Provider Demographics
NPI:1992398051
Name:GLOVER, ALEXIS BRIDGES (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:BRIDGES
Last Name:GLOVER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 BLADENSBURG RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3927
Mailing Address - Country:US
Mailing Address - Phone:404-401-1010
Mailing Address - Fax:
Practice Address - Street 1:6 DUPONT CIR NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1108
Practice Address - Country:US
Practice Address - Phone:202-785-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC003623363LF0000X
VA0024181281363LF0000X, 363LF0000X
DCRN1028339363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily