Provider Demographics
NPI:1609642081
Name:GLOMB, MARIE S (RN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:S
Last Name:GLOMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 MOYHEND ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1348
Mailing Address - Country:US
Mailing Address - Phone:724-980-1582
Mailing Address - Fax:
Practice Address - Street 1:7165 CHURCHLAND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1217
Practice Address - Country:US
Practice Address - Phone:412-441-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN590738163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice