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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GLEN P REVERE, R.D., C.D.E.

Active Sole Proprietor

GLEN P REVERE, R.D., C.D.E. is a Registered Dietitian healthcare provider located in PARKER, Arizona. NPI 1477628980 is currently active in the NPPES registry. Verify at CMS.

Registered Dietitian · PARKER, AZ

Registration Details

NPI Number
1477628980
Provider Type
Individual
Gender
Male
NPI Issued
Nov 21, 2006 (19.687771877919 yrs)
Last Updated
Jul 8, 2007
License
473669
Sole Proprietor
Yes

Practice Information

Address
12033 AGENCY RD
PARKER, AZ, 853447718
Browse AZ providers · Browse ZIP 85344
Phone
9286692137
Fax
9286693131
Primary Specialty
Registered Dietitian
133V00000X

Other Registered Dietitian Providers in PARKER, AZ

Name Credential NPI
ANN M FARRAR R.D. 1821306333
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.