Provider Demographics
NPI:1518099936
Name:OLIVE, DARLENE B (RN,NCC WH NP, APN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:B
Last Name:OLIVE
Suffix:
Gender:F
Credentials:RN,NCC WH NP, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 RUSSELL HURST DR E
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-1965
Mailing Address - Country:US
Mailing Address - Phone:901-544-7600
Mailing Address - Fax:901-544-7602
Practice Address - Street 1:814 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-5041
Practice Address - Country:US
Practice Address - Phone:901-544-7597
Practice Address - Fax:901-544-7602
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011403163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000011403OtherTN APN LICENSE #
0000058425OtherRN LICENSE