Provider Demographics
NPI:1912751793
Name:OLIVER, BRANDI (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:FISHING CREEK
Mailing Address - State:MD
Mailing Address - Zip Code:21634-0064
Mailing Address - Country:US
Mailing Address - Phone:443-813-2892
Mailing Address - Fax:
Practice Address - Street 1:511 IDLEWILD AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3888
Practice Address - Country:US
Practice Address - Phone:410-822-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily