Provider Demographics
NPI:1649750035
Name:GLENTZER, CYNTHIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:GLENTZER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 S SHOREVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-8809
Mailing Address - Country:US
Mailing Address - Phone:317-501-1112
Mailing Address - Fax:
Practice Address - Street 1:5230 E STOP 11 RD STE 190
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6399
Practice Address - Country:US
Practice Address - Phone:317-528-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28126487A207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine