Provider Demographics
NPI:1548618481
Name:GLOVER, ANNALIESE D'ARCY (NP-C)
Entity Type:Individual
Prefix:
First Name:ANNALIESE
Middle Name:D'ARCY
Last Name:GLOVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 WELBORN ST
Mailing Address - Street 2:# 425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5205
Mailing Address - Country:US
Mailing Address - Phone:972-978-3689
Mailing Address - Fax:
Practice Address - Street 1:1021 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3443
Practice Address - Country:US
Practice Address - Phone:817-225-4591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily