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NPI Code Detail

MEDICARE: JASMINE GLOVER (RN)

MEDICARE: JASMINE GLOVER (RN)
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
1163W00000XRegistered Nurse539679OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912604364
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE GLOVER (RN)
Provider Business Mailing Address
First Line : 714 OTTERBEIN AVE
Second Line :
City : DAYTON
State : OH
Zip : 45406-4007
Country : US
Telephone Number : 937-329-6437
Fax Number :
Provider Business Practice Location Address
First Line : 3411 OFFICE PARK DR
Second Line :
City : DAYTON
State : OH
Zip : 45439-2298
Country : US
Telephone Number : 937-802-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2023
Last Update Date : 10/09/2024

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