Healthcare Provider Details

I. General information

NPI: 1023544079
Provider Name (Legal Business Name): BRITNEY MARIE GLOVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/25/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 CHESTER BLVD. REID PEDIATRIC & INTERNAL MEDICINE
RICHMOND IN
47374-1919
US

IV. Provider business mailing address

1100 REID PARKWAY MEDICAL STAFF SERVICES
RICHMOND IN
47374
US

V. Phone/Fax

Practice location:
  • Phone: 765-966-5527
  • Fax: 765-966-5528
Mailing address:
  • Phone: 765-983-3127
  • Fax: 765-983-3219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71007044A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: