Provider Demographics
NPI:1891024725
Name:OLIVER, MELISSA (DOULA)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 SEAGIRT BLVD
Mailing Address - Street 2:#6A
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2945
Mailing Address - Country:US
Mailing Address - Phone:917-515-4867
Mailing Address - Fax:
Practice Address - Street 1:2037 SEAGIRT BLVD
Practice Address - Street 2:#6A
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-2945
Practice Address - Country:US
Practice Address - Phone:917-515-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula