Anderson, Glen Davis

Anderson, Glen Davis is an individual health care provider with primary practice located at 1 Medical Center Dr , Lebanon NH 03756-1000. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Anderson, Glen Davis can be contacted via phone (603) 650-5922.

Contact Information

Primary practice address
1 Medical Center Dr Lebanon NH 03756-1000
Phone: (603) 650-5922
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 031334-23-11 New Hampshire
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1010049041 Vermont

Profile Details

NPI number 1245268366
LBN Legal business name Anderson, Glen Davis
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jan 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245268366 NPPES
Vermont MEDICAID 1005698

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