Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Glen P Revere, RD, CDE

Individual provider Registered Dietitian · NPI 1477628980

Glen P Revere, RD, CDE is a Registered Dietitian in Parker, Arizona. Practices as a sole proprietor. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
CDE — Certified Diabetes Educator
Teaches people to manage diabetes day to day.

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Practice location Address checks out

12033 Agency Rd
Parker, AZ 85344-7718
Phone: (928) 669-2137
Fax: (928) 669-3131
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 473669

Record details

NPI number1477628980
Entity typeIndividual (Type 1)
GenderMale
Credentials RD , CDE
Sole proprietorYes
NPI enumeratedNovember 21, 2006
Last updated in NPPESJuly 8, 2007

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