Provider Demographics
NPI:1447066345
Name:METOYER, GLENNA MARIE
Entity type:Individual
Prefix:
First Name:GLENNA
Middle Name:MARIE
Last Name:METOYER
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 1:7732 WINDSOR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3566
Mailing Address - Country:US
Mailing Address - Phone:469-235-2016
Mailing Address - Fax:
Practice Address - Street 1:7732 WINDSOR
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-3566
Practice Address - Country:US
Practice Address - Phone:469-235-2016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLL-22762163WL0100X
TXL-22762163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant