Individual
KIMBERLY K OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 531-2000
Mailing address
PO BOX 2759, APPLETON, WI 54912-2759
(920) 830-5900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0191
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
6607-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
01
—
P00839047
RAILROAD MEDICARE
MN
Enumeration date
04/07/2010
Last updated
10/03/2024
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