Provider Demographics
NPI:1750710513
Name:GLENN, AMANDA L (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:GLENN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:43 W RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1711
Mailing Address - Country:US
Mailing Address - Phone:610-226-6200
Mailing Address - Fax:610-226-6201
Practice Address - Street 1:43 W RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1711
Practice Address - Country:US
Practice Address - Phone:610-226-6200
Practice Address - Fax:610-226-6201
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2019-12-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical