Judy Sholar Glover, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Raleigh, NC
NPI 1073667697 · NPPES record last updated Nov 11, 2014
Key facts
- NPI
- 1073667697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 29110 (NC)
- Practice address
- 4420 Lake Boone TRL
Raleigh, NC 27607-7505 - Phone
- (919) 784-3034
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29110 | NC | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 29110 | NC | Yes |
Addresses
Primary practice location
4420 Lake Boone TRL
Raleigh, NC 27607-7505
Mailing address
3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616-2880
Phone (919) 873-9533
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430031002 | Other | NC | RAILROAD-MEDICARE |
| 8050107 | Medicaid | NC |
Other providers in Raleigh, NC
- Aaron Glover
- Alan Cole Glover
- Courtney Viviana Glover
- Darryl E Glover Jr.
- Franklin Glover
- Krystal Kirby Glover
- Mikaela Glover
- Penny Glover
- Yolonda M Glover
- Glow Care Support, PLLC
All providers in Raleigh, NC · Certified Registered Nurse Anesthetist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.