| Mrs Glenda Faye Ganus, FNP | |
|
14634 Saint Stephens Ave, Chatom, AL 36518-6711 | |
| (251) 847-6262 | |
| (251) 847-6277 |
| Full Name | Mrs Glenda Faye Ganus |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 14634 Saint Stephens Ave, Chatom, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699775643 | NPI | - | NPPES |
| 051516689 | Other | AL | MEDICARE ID |
| 529700760 | Medicaid | AL | |
| 541003926 | Other | AL | MEDICAID GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 1-031341 (Alabama) | Primary |
| 363L00000X | Nurse Practitioner | R856711 (Mississippi) | Secondary |
| Entity Name | Chatom Primary Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730158544 PECOS PAC ID: 9537187380 Enrollment ID: O20051109001188 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Glenda Faye Ganus, FNP Po Box 1237, Chatom, AL 36518-1237 Ph: (251) 847-6262 | Mrs Glenda Faye Ganus, FNP 14634 Saint Stephens Ave, Chatom, AL 36518-6711 Ph: (251) 847-6262 |
Candy M Williams, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14634 Saint Stephens Ave, Chatom, AL 36518 Phone: 251-847-6262 Fax: 251-847-6262 | |
Melissa Susan Williams, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14714 St Stephens Ave, Chatom, AL 36518 Phone: 251-847-6262 Fax: 251-847-6277 | |
Carli Taylor, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14714 St. Stephens Ave, Chatom, AL 36518 Phone: 251-544-6407 Fax: 251-544-6406 | |
Mrs. Tonya Elaine Anderson, MSN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14634 Saint Stephens Ave, Chatom, AL 36518 Phone: 251-847-6262 Fax: 251-847-6277 | |
Charlotte Annette Moss, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14634 Saint Stephens Ave, Chatom, AL 36518 Phone: 251-847-6262 Fax: 251-847-6277 | |
Braeden Harding Turner, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14634 Saint Stephens Ave, Chatom, AL 36518 Phone: 251-847-6262 |