NPI 1992877963 · live from the CMS NPI Registry
Glen Marvin Intermill, CRNFA
Registered Nurse, Registered Nurse First Assistant in Eagle Point, OR. National Provider Identifier 1992877963, active.
NPI record
| NPI | 1992877963 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Registered Nurse First Assistant 163WR0006X |
| Practice location | 1222 Craiglea Dr, Eagle Point, OR 97524 |
| Practice phone | 541-535-3820 |
| Enumerated | November 15, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Registered Nurse First Assistant primary | 163WR0006X | 096006492RN (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.