Provider Demographics
NPI:1457433070
Name:OLIVER, DOROTHY W (RN,ARNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:W
Last Name:OLIVER
Suffix:
Gender:F
Credentials:RN,ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 SPRING CENTRE SOUTH BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1974
Mailing Address - Country:US
Mailing Address - Phone:407-862-1108
Mailing Address - Fax:
Practice Address - Street 1:1180 SPRING CENTRE SOUTH BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-1974
Practice Address - Country:US
Practice Address - Phone:407-862-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1456452363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health