Provider Demographics
NPI:1689126591
Name:GLENN, JULIA (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GLENN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9159 W THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4910
Mailing Address - Country:US
Mailing Address - Phone:623-933-7453
Mailing Address - Fax:623-974-3870
Practice Address - Street 1:10503 W THUNDERBIRD BLVD
Practice Address - Street 2:366
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3022
Practice Address - Country:US
Practice Address - Phone:623-933-7453
Practice Address - Fax:623-974-3870
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2021-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ6213363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant