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Sullivan Thomas Glover, RN

Registered Nurse in Cheyenne, WY. Individual provider (NPI-1).

NPI number1104671007
StatusActive
Last updated in NPPESApr 23, 2024

Details

NPI
1104671007
Entity type
Individual (NPI-1)
Name
Sullivan Thomas Glover
Credential
RN
Sex
Male
Sole proprietor
No
Enumeration date
Apr 23, 2024
Certification date
Apr 23, 2024
Last updated
Apr 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163W00000X Registered Nurse48989WYYes

Practice location

2360 E Pershing Blvd
Cheyenne, WY 82001-5356

Phone 307-778-7550

Mailing address

3537 Pierce Ave
Cheyenne, WY 82001-2136

Phone 307-214-3585

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