Provider Demographics
NPI:1386688398
Name:OLIVER, DIANA L (ARNP)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:L
Last Name:OLIVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 REGENCY SQUARE BLVD STE 903
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-8116
Mailing Address - Country:US
Mailing Address - Phone:904-725-6463
Mailing Address - Fax:904-329-2349
Practice Address - Street 1:9550 REGENCY SQUARE BLVD STE 903
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-8116
Practice Address - Country:US
Practice Address - Phone:904-725-6463
Practice Address - Fax:904-329-2349
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2995612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner