Provider Demographics
NPI:1093596371
Name:GLAVAN, KLAUDIA (CD)
Entity Type:Individual
Prefix:
First Name:KLAUDIA
Middle Name:
Last Name:GLAVAN
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 NE FATIMA TER
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1209
Mailing Address - Country:US
Mailing Address - Phone:772-925-2290
Mailing Address - Fax:
Practice Address - Street 1:138 NE FATIMA TER
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1209
Practice Address - Country:US
Practice Address - Phone:772-925-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202309219374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula