Provider Demographics
NPI:1861904377
Name:GLENN, ASHTON JEANETTE (ARPN- CNP)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:JEANETTE
Last Name:GLENN
Suffix:
Gender:F
Credentials:ARPN- CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11771 HERPEL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-6057
Mailing Address - Country:US
Mailing Address - Phone:870-214-0587
Mailing Address - Fax:
Practice Address - Street 1:316 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560
Practice Address - Country:US
Practice Address - Phone:870-269-8700
Practice Address - Fax:888-807-4056
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily