Provider Demographics
NPI:1538712161
Name:GLANCE, OLIVIA (PMHNP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:GLANCE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 DOUGLAS ST STE 500
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6616
Mailing Address - Country:US
Mailing Address - Phone:919-767-0214
Mailing Address - Fax:919-797-1250
Practice Address - Street 1:615 DOUGLAS ST STE 500
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6616
Practice Address - Country:US
Practice Address - Phone:919-767-0214
Practice Address - Fax:919-797-1250
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5012033363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health