Provider Demographics
NPI:1639345648
Name:GLISCHINSKI, NICOLE MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:GLISCHINSKI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:STE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:9399 CROWN CREST BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8506
Practice Address - Country:US
Practice Address - Phone:303-840-1472
Practice Address - Fax:303-840-1473
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2019-06-13
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Provider Licenses
StateLicense IDTaxonomies
CO2379363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical