Provider Demographics
NPI:1205461985
Name:GLOSSON, ASHLEY BURNETTE (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BURNETTE
Last Name:GLOSSON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PERSHING AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-6505
Mailing Address - Country:US
Mailing Address - Phone:210-857-0999
Mailing Address - Fax:
Practice Address - Street 1:9139 WESTOVER HILLS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2885
Practice Address - Country:US
Practice Address - Phone:210-437-3990
Practice Address - Fax:210-437-3991
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143750363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics