Provider Demographics
NPI:1336537166
Name:GLENN, ASHLEY PPOOL (IBCLC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PPOOL
Last Name:GLENN
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 SHADYBROOK CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8218
Mailing Address - Country:US
Mailing Address - Phone:615-812-7856
Mailing Address - Fax:
Practice Address - Street 1:755 SHADYBROOK CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8218
Practice Address - Country:US
Practice Address - Phone:615-812-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-157460174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN