Provider Demographics
NPI:1639705486
Name:GLENN, MERIBETH M (TM)
Entity Type:Individual
Prefix:MRS
First Name:MERIBETH
Middle Name:M
Last Name:GLENN
Suffix:
Gender:F
Credentials:TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W TALL OAK LN
Mailing Address - Street 2:
Mailing Address - City:BOYERS
Mailing Address - State:PA
Mailing Address - Zip Code:16020-2214
Mailing Address - Country:US
Mailing Address - Phone:724-992-0047
Mailing Address - Fax:
Practice Address - Street 1:317 W TALL OAK LN
Practice Address - Street 2:
Practice Address - City:BOYERS
Practice Address - State:PA
Practice Address - Zip Code:16020-2214
Practice Address - Country:US
Practice Address - Phone:724-992-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No175M00000XOther Service ProvidersMidwife, Lay
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty