Doctor Name: | HEATHER LEANN GLOVER |
NPI Number: | 1265794564 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | A03298 ANP |
Business Practice Address: | 417 W Main St Trumann, AR - 724723116 |
Business Phone Number: | 8704831025 |
Business Fax Number: | |
Mailing Address: | 6058 Beaver Dam Ln, JONESBORO |
State: | AR |
Postal Code: | 724049650 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/12/2012 |
NPI Last Update Date: | 01/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A03298 ANP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |