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NPI Code Detail

MEDICARE: SUSAN M GLOSE ANP

MEDICARE:   SUSAN M GLOSE  ANP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerF303051NY
2363LA2200XAdult Health Nurse Practitioner5010121NC

General Provider Information

NPI Number : 1326013590
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M GLOSE ANP
Provider Business Mailing Address
First Line : PO BOX 15109
Second Line :
City : WILMINGTON
State : NC
Zip : 28408-5109
Country : US
Telephone Number : 910-392-2525
Fax Number : 910-392-2827
Provider Business Practice Location Address
First Line : 1709 S 16TH ST STE A
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6491
Country : US
Telephone Number : 910-452-8633
Fax Number : 910-452-8569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 02/10/2021

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Directions to “ SUSAN M GLOSE ANP” Practice Location

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