Provider Demographics
NPI:1952087173
Name:GLOVER, JILLIAN ELIZABETH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:ELIZABETH
Last Name:GLOVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:ELIZABETH
Other - Last Name:JOLLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:933 N 104TH ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-3207
Mailing Address - Country:US
Mailing Address - Phone:623-521-1735
Mailing Address - Fax:
Practice Address - Street 1:1955 W GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7487
Practice Address - Country:US
Practice Address - Phone:480-827-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ294674363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner