Provider Demographics
NPI:1659913283
Name:OLIVER, JACQUELINE A (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:A
Last Name:OLIVER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6350 CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4107
Mailing Address - Country:US
Mailing Address - Phone:727-213-5700
Mailing Address - Fax:757-213-5701
Practice Address - Street 1:6251 E VIRGINIA BEACH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2800
Practice Address - Country:US
Practice Address - Phone:757-466-8683
Practice Address - Fax:757-466-8892
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2023-08-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant