Provider Demographics
NPI:1184378507
Name:GLOWING HEALTH SERVICES PC
Entity type:Organization
Organization Name:GLOWING HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF NURSING PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, ANP-BC
Authorized Official - Phone:201-519-4421
Mailing Address - Street 1:50 ANDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-1103
Mailing Address - Country:US
Mailing Address - Phone:201-519-4421
Mailing Address - Fax:
Practice Address - Street 1:50 ANDOVER AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-1103
Practice Address - Country:US
Practice Address - Phone:201-519-4421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty