Provider Demographics
NPI:1285219733
Name:OLIVER, ANTHONY (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:OLIVER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4069 JOHN P GREEN PL
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-5476
Mailing Address - Country:US
Mailing Address - Phone:216-295-2270
Mailing Address - Fax:
Practice Address - Street 1:5900 PARKWOOD PL FL 5
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1216
Practice Address - Country:US
Practice Address - Phone:866-458-9935
Practice Address - Fax:855-686-2798
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH243474163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice