Provider Demographics
NPI:1861657850
Name:GLENN, CONSTANCE JUDITH-HIGGINS (APRN,FNP-BC, CNE)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:JUDITH-HIGGINS
Last Name:GLENN
Suffix:
Gender:F
Credentials:APRN,FNP-BC, CNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COUNTRY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3523
Mailing Address - Country:US
Mailing Address - Phone:203-385-2435
Mailing Address - Fax:
Practice Address - Street 1:50 COUNTRY RIDGE DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3523
Practice Address - Country:US
Practice Address - Phone:203-385-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-19
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003373363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily