Provider Demographics
NPI:1356510432
Name:GLESNER, ANITA LOUISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:LOUISE
Last Name:GLESNER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 6007
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-6007
Mailing Address - Country:US
Mailing Address - Phone:517-787-8015
Mailing Address - Fax:517-787-5520
Practice Address - Street 1:3165 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-4101
Practice Address - Country:US
Practice Address - Phone:517-787-8015
Practice Address - Fax:517-787-5520
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIMG0894976363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant