Provider Demographics
NPI:1588879449
Name:GLOVER, NITA (RN,ANP)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:
Last Name:GLOVER
Suffix:
Gender:F
Credentials:RN,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 FRANKLIN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5250
Mailing Address - Country:US
Mailing Address - Phone:615-377-3448
Mailing Address - Fax:615-370-3449
Practice Address - Street 1:343 FRANKLIN RD STE 202
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5250
Practice Address - Country:US
Practice Address - Phone:615-377-3448
Practice Address - Fax:615-370-3449
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNANP0000007855174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNANP0000007855OtherSATE LIC.#
TNMG1458529OtherDEA#