Provider Demographics
NPI:1740986736
Name:GLASGOW, CHARLIE DANIELLE (RN)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:DANIELLE
Last Name:GLASGOW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:DANIELLE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:147 SARAH DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9430
Mailing Address - Country:US
Mailing Address - Phone:814-505-3932
Mailing Address - Fax:
Practice Address - Street 1:2907 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4305
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN586398163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health