# ANU GLO MED SPA, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508470212
- **Authorized official:** IVY CLEVELAND NP (OWNER)
- **Authorized official phone:** (404) 664-2505

## Contact information

- **Practice address:** 2429 MAIN ST E STE 6, SNELLVILLE, GA 30078-3336
- **Practice address phone:** (404) 664-2505
- **Mailing address:** 1573 STONEGATE WAY, SNELLVILLE, GA 30078-6701
- **Mailing address phone:** (404) 664-2505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | NULL | — |
| 363LA2100X | Acute Care Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/01/2020
- **Last updated:** 09/01/2020