Provider Demographics
NPI:1891575213
Name:GLOVER, CHERISE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHERISE
Middle Name:
Last Name:GLOVER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19076-2322
Mailing Address - Country:US
Mailing Address - Phone:610-586-6262
Mailing Address - Fax:
Practice Address - Street 1:815 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:PA
Practice Address - Zip Code:19076-2322
Practice Address - Country:US
Practice Address - Phone:610-586-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027097363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health