Provider Demographics
NPI:1053557603
Name:FEIGEN, GLENN ALLEN (LPN)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:ALLEN
Last Name:FEIGEN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 55TH AVE
Mailing Address - Street 2:POST OFFICE BOX 690292
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4601
Mailing Address - Country:US
Mailing Address - Phone:772-501-2967
Mailing Address - Fax:772-564-9504
Practice Address - Street 1:3727 SE OCEAN BLVD # 200B
Practice Address - Street 2:GENERAL HEALTHCARE RESOURCES, INC.
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996
Practice Address - Country:US
Practice Address - Phone:800-355-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN702111164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse