Provider Demographics
NPI:1538837984
Name:GLINSEY, DESTIANY NICOLE
Entity type:Individual
Prefix:
First Name:DESTIANY
Middle Name:NICOLE
Last Name:GLINSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-1443
Mailing Address - Country:US
Mailing Address - Phone:440-653-2556
Mailing Address - Fax:
Practice Address - Street 1:3008 DENVER AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1443
Practice Address - Country:US
Practice Address - Phone:440-653-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide