Individual provider · Type 1 NPI
Glen Wiley, APRN, FNP-C
Family Nurse Practitioner · Banning, CA
NPI number
1154905982
Active
Practice location
11555 Potrero Rd
Banning, CA 92220-6946
Mailing address
1647 W Ponderosa Way
Upland, CA 91784-7454
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1031197 (TX) |
| Family Nurse Practitioner | 363LF0000X | 2025038559 (MO) |
| Family Nurse Practitioner Primary | 363LF0000X | 95017368 (CA) |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1154905982
Glen Wiley, APRN, FNP-C's National Provider Identifier is 1154905982, issued on May 7, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Banning, CA. The record was last updated on Jul 14, 2026.