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General NPI Number Information
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NPI Number | 1952912511
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Entity Type | Individual
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Provider Name | ALEXANDRA MAE GLOOR FNP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2020
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 180 ATWATER ST N
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City | MONMOUTH
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State | OR
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Zip | 97361-1801
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Country | US
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Telephone | 503-606-3287
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Fax |
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Provider Business Mailing Address
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Address Line | 257 NW HILLCREST DR
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City | DALLAS
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State | OR
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Zip | 97338-1030
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Country | US
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Telephone | 845-594-2187
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 291078
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 202206138NP-PP
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License Number State | OR
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