Provider Demographics
NPI:1982939377
Name:GLOVER, SHARRON MARIE (CNA LPN ESTATE OWNER)
Entity Type:Individual
Prefix:MRS
First Name:SHARRON
Middle Name:MARIE
Last Name:GLOVER
Suffix:
Gender:F
Credentials:CNA LPN ESTATE OWNER
Other - Prefix:
Other - First Name:SHARRON
Other - Middle Name:MARIE
Other - Last Name:GLOVER ARMSTEAD JR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 51661
Mailing Address - Street 2:107 WEST CORNWALLIS RD
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717
Mailing Address - Country:US
Mailing Address - Phone:919-599-7193
Mailing Address - Fax:
Practice Address - Street 1:107 WEST CORNWALLIS RD
Practice Address - Street 2:
Practice Address - City:DURHAM COUNTY
Practice Address - State:NC
Practice Address - Zip Code:27717
Practice Address - Country:US
Practice Address - Phone:919-599-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC$$$$$$$$$Medicaid