Healthcare Provider Details

I. General information

NPI: 1982037818
Provider Name (Legal Business Name): JAMIE CASH GLOVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 PEMBERTON HILL RD STE 101
APEX NC
27502-4278
US

IV. Provider business mailing address

1031 PEMBERTON HILL RD STE 101
APEX NC
27502-4278
US

V. Phone/Fax

Practice location:
  • Phone: 919-303-2255
  • Fax:
Mailing address:
  • Phone: 919-303-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5006359
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: