Provider Demographics
NPI:1285887570
Name:GLOVER, JANIS A (NP)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:A
Last Name:GLOVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 DANIELS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4710
Mailing Address - Country:US
Mailing Address - Phone:239-416-8101
Mailing Address - Fax:239-402-8601
Practice Address - Street 1:681 GOODLETTE RD STE 210
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5612
Practice Address - Country:US
Practice Address - Phone:239-374-5223
Practice Address - Fax:239-510-4038
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9211877363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1235373OtherWELLCARE
FLP01220226OtherRR MEDICARE
FLP1000448OtherFREEDOM
FL398639OtherAVMED
FLP01220226OtherRAILROAD MCR
FLP958310OtherOPTIMUM
FL7185636OtherCIGNA
FL5623854OtherAETNA
FLP01807773OtherCLEAR HEALTH ALLIANCE
FLY01Z7OtherBCBS OF FL
FL5623854OtherAETNA