Provider Demographics
NPI:1083861504
Name:OLIVER, DANA KATTER (NP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KATTER
Last Name:OLIVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LITTLETON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3115
Mailing Address - Country:US
Mailing Address - Phone:978-577-0437
Mailing Address - Fax:978-692-9904
Practice Address - Street 1:100 BOSTON RD
Practice Address - Street 2:SUITE F
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1879
Practice Address - Country:US
Practice Address - Phone:978-577-0437
Practice Address - Fax:978-448-6707
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274414363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3102812Medicaid
MA110105474AMedicaid
MA5882760OtherAETNA