Provider Demographics
NPI:1013782457
Name:GLOVER, DIANNA MICHELLE (BSN, RN, FNP-S)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:MICHELLE
Last Name:GLOVER
Suffix:
Gender:F
Credentials:BSN, RN, FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 S GATEHOUSE DR APT C
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7825
Mailing Address - Country:US
Mailing Address - Phone:318-308-2773
Mailing Address - Fax:
Practice Address - Street 1:13800 OLD GENTILLY RD BLDG 320
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-2218
Practice Address - Country:US
Practice Address - Phone:504-257-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily