Provider Demographics
NPI:1336823129
Name:OLIVERO, NANCY (RDN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:OLIVERO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SANTA MARIA
Mailing Address - Street 2:128 MIMOSA ST.
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-243-0175
Mailing Address - Fax:
Practice Address - Street 1:URB SANTA MARIA
Practice Address - Street 2:128 MIMOSA ST.
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6213
Practice Address - Country:US
Practice Address - Phone:787-243-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR867116133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered