Provider Demographics
NPI:1215603444
Name:GLOVER, NICOLA MEJER
Entity type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:MEJER
Last Name:GLOVER
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 1:2671 SOUTH AVE # 171
Mailing Address - Street 2:
Mailing Address - City:BRYN ATHYN
Mailing Address - State:PA
Mailing Address - Zip Code:19009-8021
Mailing Address - Country:US
Mailing Address - Phone:240-696-9405
Mailing Address - Fax:
Practice Address - Street 1:1600 HORIZON DR STE 121
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-4100
Practice Address - Country:US
Practice Address - Phone:267-477-1446
Practice Address - Fax:267-477-1448
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3822237700000X
PAAT006900231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFO3822OtherHEARING AID DISPENSER LICENSE