Provider Demographics
NPI:1265146559
Name:OLIVER, ADRIENNE L
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:L
Last Name:OLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:L
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADRIENNE HANEY
Mailing Address - Street 1:4700 S RIDGE RD APT 6316
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2283
Mailing Address - Country:US
Mailing Address - Phone:414-881-0886
Mailing Address - Fax:
Practice Address - Street 1:4700 S RIDGE RD APT 6316
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2283
Practice Address - Country:US
Practice Address - Phone:414-881-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X
275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit