Glenn Rivers Jr., RN
Registered Nurse in Fort Myers, FL. Individual provider (NPI-1).
NPI number1649616632
StatusActive
Last updated in NPPESMay 30, 2013
Details
- NPI
- 1649616632
- Entity type
- Individual (NPI-1)
- Name
- Glenn Rivers Jr.
- Credential
- RN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2013
- Last updated
- May 30, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN 9290432 | FL | Yes |
| 163W00000X | Registered Nurse | 575479 | NY |
Practice location
10140 Deer Run Farms RdFort Myers, FL 33966-1045
Phone 239-275-7356
Mailing address
2789 Ortiz AveFort Myers, FL 33905-7806
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