Provider Demographics
NPI:1780369140
Name:GLASS, VALERIE ELIZABETH (CRNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ELIZABETH
Last Name:GLASS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HAMPTON GATE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3312
Mailing Address - Country:US
Mailing Address - Phone:251-776-2159
Mailing Address - Fax:
Practice Address - Street 1:6701 AIRPORT BLVD STE A101
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6767
Practice Address - Country:US
Practice Address - Phone:251-660-3510
Practice Address - Fax:251-660-3511
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109132363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care