Provider Demographics
NPI:1841068962
Name:GLAESER, GRETA JANE (MSN, AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:GRETA
Middle Name:JANE
Last Name:GLAESER
Suffix:
Gender:F
Credentials:MSN, AGNP-C
Other - Prefix:MRS
Other - First Name:GRETA
Other - Middle Name:JANE GLAESER
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, AGPCNP
Mailing Address - Street 1:185 HARRY S TRUMAN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7580
Mailing Address - Country:US
Mailing Address - Phone:410-263-4171
Mailing Address - Fax:
Practice Address - Street 1:185 HARRY S TRUMAN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7580
Practice Address - Country:US
Practice Address - Phone:410-263-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR239652363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health