Provider Demographics
NPI:1942863675
Name:GLOVER, LAURA LEA (LVN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10431 FM 2262
Mailing Address - Street 2:
Mailing Address - City:GROVETON
Mailing Address - State:TX
Mailing Address - Zip Code:75845-2695
Mailing Address - Country:US
Mailing Address - Phone:936-676-0602
Mailing Address - Fax:
Practice Address - Street 1:10431 FM 2262
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-2695
Practice Address - Country:US
Practice Address - Phone:936-676-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214461164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse