Healthcare Provider Details

I. General information

NPI: 1326698861
Provider Name (Legal Business Name): JENNIFER NICOLE GLORIOSO CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER PEMBERTON RN

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 S QUEEN ST STE 200
YORK PA
17403-4829
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-2316
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010873
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: