Provider Demographics
NPI:1710212766
Name:OLIVER, GINA M (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:M
Last Name:OLIVER
Suffix:
Gender:F
Credentials:FNP-BC
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Mailing Address - Street 1:850 W HOSPITAL DR STE F
Mailing Address - Street 2:FULTON MEDICAL CLINIC
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65043
Mailing Address - Country:US
Mailing Address - Phone:573-642-5338
Mailing Address - Fax:573-642-9224
Practice Address - Street 1:850 W HOSPITAL DR
Practice Address - Street 2:STE F
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251
Practice Address - Country:US
Practice Address - Phone:573-642-5338
Practice Address - Fax:573-642-9224
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2013-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO093039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily