Provider Demographics
NPI:1093295164
Name:ADWERE, GLORIA (FNP)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:ADWERE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 CONCOURSE LOOP
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-8200
Mailing Address - Country:US
Mailing Address - Phone:614-772-7710
Mailing Address - Fax:
Practice Address - Street 1:6760 TUSSING RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4129
Practice Address - Country:US
Practice Address - Phone:614-626-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2023-03-20
Deactivation Date:2022-06-14
Deactivation Code:
Reactivation Date:2023-03-17
Provider Licenses
StateLicense IDTaxonomies
OH409257163WP0200X
OH0031496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0031496OtherAPRN
OHRN409257OtherOHIO BOARD OF NURSING