Individual
BRANDY TOLLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3810 PACIFIC BLVD SW, ALBANY, OR 97321-7752
(541) 936-7549
Mailing address
PO BOX 13129, SALEM, OR 97309-1129
(503) 814-1472
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209015879
IL
363LG0600X
Gerontology Nurse Practitioner
209015879
IL
Other
Enumeration date
04/15/2017
Last updated
04/29/2025
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