Provider Demographics
NPI:1952364382
Name:GLAZER, KATHRYN BATTEN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:BATTEN
Last Name:GLAZER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 NW 42ND RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4280
Mailing Address - Country:US
Mailing Address - Phone:352-378-8934
Mailing Address - Fax:352-372-1169
Practice Address - Street 1:6434 NW 42ND RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4280
Practice Address - Country:US
Practice Address - Phone:352-378-8934
Practice Address - Fax:352-372-1169
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP450192363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY068VOtherBCBS
FL306748300Medicaid
FLS89556Medicare UPIN