Provider Demographics
NPI:1386431799
Name:GLENN, HERMINIA ANEL-PACE (RN)
Entity type:Individual
Prefix:MS
First Name:HERMINIA
Middle Name:ANEL-PACE
Last Name:GLENN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:HALEN
Other - Middle Name:ANEL-PACE
Other - Last Name:GLENN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:4924 N CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-3557
Mailing Address - Country:US
Mailing Address - Phone:641-223-0358
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST LEVEL 1
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024000835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse