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General NPI Number Information
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NPI Number | 1578496667
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Entity Type | Individual
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Provider Name | EBONY NICOLE GLOVER RN,BSN
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Gender | Female
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 136 STONEMARK LN
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City | COLUMBIA
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State | SC
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Zip | 29210-3881
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Country | US
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Telephone | 803-837-8742
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Fax |
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Provider Business Mailing Address
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Address Line | 39 ROSEMARY CT
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City | COLUMBIA
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State | SC
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Zip | 29229-7064
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Country | US
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Telephone | 803-837-8742
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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 | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 255955
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License Number State | SC
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