Provider Demographics
NPI:1871668954
Name:GLASS, CHERYL ANNE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANNE
Last Name:GLASS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4485 S TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-4206
Mailing Address - Country:US
Mailing Address - Phone:615-847-8428
Mailing Address - Fax:
Practice Address - Street 1:4485 S TRACE BLVD
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-4206
Practice Address - Country:US
Practice Address - Phone:615-847-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000052333T163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory