Provider Demographics
NPI:1164638615
Name:OLVER, KATHLEEN M (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:OLVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:VELK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:826 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-4636
Mailing Address - Country:US
Mailing Address - Phone:406-390-4434
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 67
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:MT
Practice Address - Zip Code:59526-9705
Practice Address - Country:US
Practice Address - Phone:406-353-3100
Practice Address - Fax:406-353-3229
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT 19179163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTMT 19179OtherLICENSE