Provider Demographics
NPI:1740218726
Name:GLENN, CYNTHIA JANE (LM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JANE
Last Name:GLENN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-3850
Mailing Address - Country:US
Mailing Address - Phone:864-329-0010
Mailing Address - Fax:864-373-9063
Practice Address - Street 1:111 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-3850
Practice Address - Country:US
Practice Address - Phone:864-329-0010
Practice Address - Fax:864-373-9063
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLMW-025176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife