Provider Demographics
NPI:1255572608
Name:GLAVEN, ANNE PATRICIA (NP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:PATRICIA
Last Name:GLAVEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 KILVERT ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1360
Mailing Address - Country:US
Mailing Address - Phone:401-408-3547
Mailing Address - Fax:
Practice Address - Street 1:1950 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02852-1012
Practice Address - Country:US
Practice Address - Phone:401-294-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37276363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health