Guerrero, Glory Ivelisse

Guerrero, Glory Ivelisse is an individual health care provider with primary practice located at 1696 Se Hillmoor Dr , Port St Lucie FL 34952-7699. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Guerrero, Glory Ivelisse can be contacted via phone (772) 692-2024.

Contact Information

Primary practice address
1696 Se Hillmoor Dr Port St Lucie FL 34952-7699
Phone: (772) 692-2024
Fax: (772) 692-1555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X ARNP9202595 Florida

Profile Details

NPI number 1427032028
LBN Legal business name Guerrero, Glory Ivelisse
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Nov 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427032028 NPPES
Florida MEDICAID 307100600

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