Provider Demographics
NPI:1639129760
Name:OLIVER, CAROL JAYNE (MSN, NNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JAYNE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MSN, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SAWGRASS CORPORATE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2823
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:855-527-5510
Practice Address - Street 1:2018 CLINCH AVENUE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2393
Practice Address - Country:US
Practice Address - Phone:865-541-8000
Practice Address - Fax:855-527-5510
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000010744363LC0200X
TN0000010744363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine