Provider Demographics
NPI:1821186529
Name:GLENN, RENEE L (MD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:L
Last Name:GLENN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1011 GASSERWAY CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8514
Mailing Address - Country:US
Mailing Address - Phone:615-377-0137
Mailing Address - Fax:615-377-0635
Practice Address - Street 1:460 9TH AVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2010
Practice Address - Country:US
Practice Address - Phone:615-459-6811
Practice Address - Fax:615-459-0371
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0150592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA99632Medicare UPIN