Provider Demographics
NPI:1871257410
Name:GLOVER, DONNA B
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:B
Last Name:GLOVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 RED OAK LN
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-9743
Mailing Address - Country:US
Mailing Address - Phone:304-536-2271
Mailing Address - Fax:
Practice Address - Street 1:200 ASSOCIATION DR STE 130
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1277
Practice Address - Country:US
Practice Address - Phone:304-988-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker