Provider Demographics
NPI:1417719634
Name:GLOVER, RACHELLE SUE (DNP/FNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:SUE
Last Name:GLOVER
Suffix:
Gender:F
Credentials:DNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 PARK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3155
Mailing Address - Country:US
Mailing Address - Phone:434-654-2760
Mailing Address - Fax:
Practice Address - Street 1:1646 PARK RIDGE DR
Practice Address - Street 2:
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22932-3155
Practice Address - Country:US
Practice Address - Phone:434-654-2760
Practice Address - Fax:434-823-4272
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily