Provider Demographics
NPI:1407621709
Name:GLOVER ROSS, DEPAULA ARNIT (CPT)
Entity Type:Individual
Prefix:
First Name:DEPAULA
Middle Name:ARNIT
Last Name:GLOVER ROSS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:DEPAULA
Other - Middle Name:ARNIT
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT
Mailing Address - Street 1:1910 MADISON AVE # 2619
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2620
Mailing Address - Country:US
Mailing Address - Phone:901-562-3230
Mailing Address - Fax:
Practice Address - Street 1:5865 RIDGEWAY CENTER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4014
Practice Address - Country:US
Practice Address - Phone:901-621-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA5H7R4Z7246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy