Provider Demographics
NPI:1437279791
Name:HARGRAVE, GLORIANE BOND (MSN, APRN,FNP-BC)
Entity type:Individual
Prefix:
First Name:GLORIANE
Middle Name:BOND
Last Name:HARGRAVE
Suffix:
Gender:F
Credentials:MSN, APRN,FNP-BC
Other - Prefix:
Other - First Name:GLORIANE
Other - Middle Name:
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:76 ORINDA DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E DAVIS ST
Practice Address - Street 2:STE A
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-3102
Practice Address - Country:US
Practice Address - Phone:409-766-1888
Practice Address - Fax:936-539-4668
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP106104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144410101Medicaid
TX144410102Medicaid
TX144410102Medicaid