Provider Demographics
NPI:1013328541
Name:OLIVIERI, BROOKE LYNN
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:LYNN
Last Name:OLIVIERI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:BROOKE
Other - Middle Name:LYNN
Other - Last Name:OLIVIERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:OH
Mailing Address - Zip Code:45812
Mailing Address - Country:US
Mailing Address - Phone:419-371-3725
Mailing Address - Fax:
Practice Address - Street 1:405 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALGER
Practice Address - State:OH
Practice Address - Zip Code:45812
Practice Address - Country:US
Practice Address - Phone:419-371-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health