Healthcare Provider Details

I. General information

NPI: 1215603444
Provider Name (Legal Business Name): MRS. NICOLA MEJER GLOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HORIZON DR STE 121
CHALFONT PA
18914-4100
US

IV. Provider business mailing address

2671 SOUTH AVE # 171
BRYN ATHYN PA
19009-8021
US

V. Phone/Fax

Practice location:
  • Phone: 267-477-1446
  • Fax: 267-477-1448
Mailing address:
  • Phone: 240-696-9405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006900
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberFO3822
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: