Provider Demographics
NPI:1811013410
Name:GLOVER, KARINA CHERYL (PA)
Entity Type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:CHERYL
Last Name:GLOVER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11605 MERIDIAN MARKET VW
Mailing Address - Street 2:SUITE 184
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-8237
Mailing Address - Country:US
Mailing Address - Phone:719-364-9555
Mailing Address - Fax:719-364-9565
Practice Address - Street 1:11605 MERIDIAN MARKET VW
Practice Address - Street 2:SUITE 184
Practice Address - City:FALCON
Practice Address - State:CO
Practice Address - Zip Code:80831-8237
Practice Address - Country:US
Practice Address - Phone:719-364-9555
Practice Address - Fax:719-364-9565
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004776363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant