Provider Demographics
NPI:1821112053
Name:GLASGOW, JEFFREY ALAN (APRN)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:GLASGOW
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Gender:M
Credentials:APRN
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Mailing Address - Street 1:1819 CLINCH AVENUE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-2435
Mailing Address - Country:US
Mailing Address - Phone:865-546-5111
Mailing Address - Fax:865-541-4018
Practice Address - Street 1:1819 CLINCH AVENUE
Practice Address - Street 2:SUITE 108
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2435
Practice Address - Country:US
Practice Address - Phone:865-546-5111
Practice Address - Fax:865-541-4018
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-06-29
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Provider Licenses
StateLicense IDTaxonomies
TNRN101012364S00000X
TNAPN7013364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3905221Medicare PIN
P60523Medicare UPIN