Glass, Lisa G

Glass, Lisa G is an individual health care provider with primary practice located at 3015 Wilson Ave , Louisville KY 40211-1969. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Glass, Lisa G can be contacted via phone (502) 774-4401.

Contact Information

Primary practice address
3015 Wilson Ave Louisville KY 40211-1969
Phone: (502) 774-4401
Fax: (502) 772-4783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 3002970 Kentucky

Profile Details

NPI number 1275534091
LBN Legal business name Glass, Lisa G
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Feb 13th, 2023 - about last year

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 1275534091 NPPES
Other 000000066843 BLUE ACCESS/BLUE PREF.
Other 61-1708562D BLUE ACCESS/BLUE PREF.
MEDICAID 78029709 BLUE ACCESS/BLUE PREF.
Other 7719001 BLUE ACCESS/BLUE PREF.

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