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Individual

SUSAN M GLOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
1709 S 16TH ST STE A, WILMINGTON, NC 28401-6491
(910) 452-8633
(910) 452-8569
Mailing address
PO BOX 15109, WILMINGTON, NC 28408-5109
(910) 392-2525
(910) 392-2827

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5010121
NC
363LA2200X
Adult Health Nurse Practitioner
F303051
NY

Other

Enumeration date
02/21/2006
Last updated
02/10/2021
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