Provider Demographics
NPI:1467894162
Name:GLOVA, MELISSA ANN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:GLOVA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13439-4035
Mailing Address - Country:US
Mailing Address - Phone:315-382-6113
Mailing Address - Fax:
Practice Address - Street 1:301 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1216
Practice Address - Country:US
Practice Address - Phone:315-867-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644634-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health