Provider Demographics
NPI:1780943258
Name:OLIVER, LIZ V (FNP)
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:V
Last Name:OLIVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4204 GARDENDALE ST
Mailing Address - Street 2:STE 312
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3132
Mailing Address - Country:US
Mailing Address - Phone:210-293-6006
Mailing Address - Fax:210-614-1722
Practice Address - Street 1:4204 GARDENDALE ST
Practice Address - Street 2:STE 312
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3132
Practice Address - Country:US
Practice Address - Phone:210-293-6006
Practice Address - Fax:210-614-1722
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP121785363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner