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General NPI Number Information
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NPI Number | 1902076672
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Entity Type | Individual
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Provider Name | LAURIE B. GLOVER FNP, BC
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Gender | Female
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Dates
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Enumeration Date | 03/09/2008
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Last Update Date | 03/09/2008
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Provider Practice Location Address
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Address Line | 401 15TH AVE S SUITE 106
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City | GREAT FALLS
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State | MT
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Zip | 59405-4334
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Country | US
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Telephone | 406-771-4443
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Fax | 406-771-4449
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Provider Business Mailing Address
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Address Line | 1318 16TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-4713
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Country | US
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Telephone | 406-761-1309
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | APRN12606
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License Number State | MT
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