Provider Demographics
NPI:1457350035
Name:OLIVER, DEBRA A (MSN, APN, RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:A
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MSN, APN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4741
Mailing Address - Country:US
Mailing Address - Phone:609-499-9313
Mailing Address - Fax:
Practice Address - Street 1:321 N WARREN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4741
Practice Address - Country:US
Practice Address - Phone:609-278-5900
Practice Address - Fax:609-392-4827
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN085904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6700900Medicaid
NJS48722Medicare UPIN
NJ6700900Medicaid