Provider Demographics
NPI:1649743972
Name:OLIVIER, DOMINIQUE (CRNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DOMINIQUE
Middle Name:
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:CRNP, 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:BON SECOURS MERCY HEALTH
Mailing Address - Street 2:2000 WEST BALTIMORE STREET
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223
Mailing Address - Country:US
Mailing Address - Phone:410-632-3627
Mailing Address - Fax:140-632-3259
Practice Address - Street 1:BON SECOURS HOSPITAL
Practice Address - Street 2:2000 WEST BALTIMORE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223
Practice Address - Country:US
Practice Address - Phone:410-362-3627
Practice Address - Fax:410-362-3259
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily