Healthcare Provider Details

I. General information

NPI: 1750224655
Provider Name (Legal Business Name): TASHIRA SHANTA GLOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 EISENHOWER DR
MONROE LA
71203-6812
US

IV. Provider business mailing address

215 EISENHOWER DR
MONROE LA
71203-6812
US

V. Phone/Fax

Practice location:
  • Phone: 318-753-2200
  • Fax: 318-753-2200
Mailing address:
  • Phone: 318-753-2200
  • Fax: 318-753-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: