Provider Demographics
NPI:1225449192
Name:GLIMSDAL, ALICIA M (APRN, CNP)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:M
Last Name:GLIMSDAL
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Gender:F
Credentials:APRN, CNP
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Mailing Address - Street 1:CENTRACARE HEALTH PAYNESVILLE HOSPITAL
Mailing Address - Street 2:200 W 1ST ST
Mailing Address - City:PAYNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56362-1445
Mailing Address - Country:US
Mailing Address - Phone:320-243-3767
Mailing Address - Fax:320-243-7519
Practice Address - Street 1:CENTRACARE HEALTH PAYNESVILLE HOSPITAL
Practice Address - Street 2:200 W 1ST ST
Practice Address - City:PAYNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56362-1445
Practice Address - Country:US
Practice Address - Phone:320-243-3767
Practice Address - Fax:320-243-7519
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2019-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN657363LA2200X, 363LG0600X, 363LP2300X
MNR 190448-0363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology