Provider Demographics
NPI:1518231729
Name:GLOSSER, HEATHER LEE (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEE
Last Name:GLOSSER
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 ORANGEVILLE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:VARYSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14167-9743
Mailing Address - Country:US
Mailing Address - Phone:585-786-0438
Mailing Address - Fax:
Practice Address - Street 1:153 W BUFFALO ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1242
Practice Address - Country:US
Practice Address - Phone:585-786-8000
Practice Address - Fax:585-786-0821
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY47389-4163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse