Provider Demographics
NPI:1962769398
Name:PICK, GLENNA RENE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:GLENNA
Middle Name:RENE
Last Name:PICK
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 1:7500 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5400
Mailing Address - Country:US
Mailing Address - Phone:727-526-4122
Mailing Address - Fax:727-525-1835
Practice Address - Street 1:7500 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5400
Practice Address - Country:US
Practice Address - Phone:727-526-4122
Practice Address - Fax:727-525-1835
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9296099363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health