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General NPI Number Information
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NPI Number | 1366912230
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Entity Type | Individual
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Provider Name | EVAN ALEXANDRA GLOVER PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 1435 GARRISON ST STE 110
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City | LAKEWOOD
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State | CO
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Zip | 80215-4748
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Country | US
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Telephone | 720-241-3765
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Fax | 720-310-7216
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Provider Business Mailing Address
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Address Line | 17507 W 61ST LN
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City | ARVADA
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State | CO
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Zip | 80403-7456
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Country | US
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Telephone | 207-218-7333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5650
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0005650
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License Number State | CO
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