MR. GLEN WILLIS, LPN

Licensed Practical Nurse

Active Individual
NPI: 1326585902

Practice Address

1807 RUGBY PL APT B
Coram, NY 11727

Phone: (631) 627-9455

Specialties

Specialty Code Primary License
Licensed Practical Nurse 164W00000X Yes 310633-1 (NY)

Frequently Asked Questions

NPI 1326585902 is the National Provider Identifier for MR. GLEN WILLIS, LPN, a Licensed Practical Nurse provider located in Coram, NY. This NPI was enumerated on January 20, 2017.
MR. GLEN WILLIS, LPN practices at 1807 RUGBY PL APT B, Coram, NY 11727.

Quick Facts

NPI
1326585902
Type
Individual
Enumerated
Jan 20, 2017
Last Updated
Jan 20, 2017

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