Provider Demographics
NPI:1639920473
Name:GLASS, ABIGAIL ROSE (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ROSE
Last Name:GLASS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ROSE
Other - Last Name:CUMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:919 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6114
Mailing Address - Country:US
Mailing Address - Phone:229-584-5400
Mailing Address - Fax:
Practice Address - Street 1:919 S BROAD ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6114
Practice Address - Country:US
Practice Address - Phone:229-584-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN312337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse