Provider Demographics
NPI:1336470012
Name:GLEBIKOWSKA, IWONA VIOLETTA (NP)
Entity Type:Individual
Prefix:
First Name:IWONA
Middle Name:VIOLETTA
Last Name:GLEBIKOWSKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 PEACHTREE PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9351
Mailing Address - Country:US
Mailing Address - Phone:678-208-2050
Mailing Address - Fax:678-208-2051
Practice Address - Street 1:763 PEACHTREE PKWY
Practice Address - Street 2:STE 2
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:678-208-2050
Practice Address - Fax:678-208-2051
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135128 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily