Individual
STACEY L GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10800 W CAPITOL DR, WAUWATOSA, WI 53222-1109
(414) 462-2373
Mailing address
10800 W CAPITOL DR, WAUWATOSA, WI 53222-1109
(414) 462-2373
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9250
WI
Other
Enumeration date
09/26/2019
Last updated
11/22/2021
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