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Individual

NANCY GLOVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
46 JORDAN AVE, SOUTH PORTLAND, ME 04106-4704
(207) 542-2788
Mailing address
46 JORDAN AVE, SOUTH PORTLAND, ME 04106-4704

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
082472-23
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP171146
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
082472-23
APRN LICENSE
NH
01
CNP171146
MAINE STATE BOARD OF NURSING
ME
Enumeration date
09/13/2017
Last updated
02/07/2021
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