Provider Demographics
NPI:1821112053
Name:GLASGOW, JEFFREY ALAN (APRN)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:GLASGOW
Suffix:
Gender:M
Credentials:APRN
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:9320 PARK WEST BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4301
Mailing Address - Country:US
Mailing Address - Phone:865-373-7100
Mailing Address - Fax:865-374-2029
Practice Address - Street 1:9320 PARK WEST BLVD STE 108
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4301
Practice Address - Country:US
Practice Address - Phone:865-373-7100
Practice Address - Fax:865-374-2029
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN7013363L00000X
TNAPN7013364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ005532Medicaid
P60523Medicare UPIN