Provider Demographics
NPI:1609498351
Name:GLATHAR, BAILEY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:ELIZABETH
Last Name:GLATHAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:ELIZABETH
Other - Last Name:HEIDTBRINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4231 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3638
Mailing Address - Country:US
Mailing Address - Phone:402-310-4931
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-3630
Practice Address - Country:US
Practice Address - Phone:402-477-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPSS-152175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist