Basic Information
Provider Information
NPI: 1073285847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GLOVER
FirstName: BRITTANY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10019 REISTERSTOWN RD FL 3
Address2:  
City: OWINGS MILLS
State: MD
PostalCode: 211173902
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 45 N CANFIELD NILES RD
Address2:  
City: YOUNGSTOWN
State: OH
PostalCode: 445152343
CountryCode: US
TelephoneNumber: 3303308777
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/30/2021
LastUpdateDate: 09/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000XLPN.176304.MED-IVOHY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


Home