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Individual

MARK GLOVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
11630 W 80TH ST, LENEXA, KS 66214-3340
(913) 752-2148
Mailing address
1419 N LUCY MONTGOMERY WAY, OLATHE, KS 66061-6707
(913) 387-9581

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
196632
NC
163WX0200X
Oncology Registered Nurse
Primary
196632
NC

Other

Enumeration date
08/15/2012
Last updated
08/15/2012
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