Provider Demographics
NPI:1053912766
Name:JONES-GLASSCOE, FELICIA (CPT)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:JONES-GLASSCOE
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 S MARTIN LUTHER KING JR BLVD # 317
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2939
Mailing Address - Country:US
Mailing Address - Phone:269-763-7130
Mailing Address - Fax:
Practice Address - Street 1:3708 MALIBU DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-1418
Practice Address - Country:US
Practice Address - Phone:517-410-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIS3P7E3X3246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy