Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Glen Willis, LPN

Individual provider Licensed Practical Nurse · NPI 1326585902

Mr. Glen Willis, LPN is a Licensed Practical Nurse in Coram, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2017
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

1807 Rugby Pl Apt B
Coram, NY 11727-5427
Phone: (631) 627-9455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 310633-1 (NY)

Record details

NPI number1326585902
Entity typeIndividual (Type 1)
GenderMale
Credentials LPN
Sole proprietorYes
NPI enumeratedJanuary 20, 2017
Last updated in NPPESJanuary 20, 2017

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