Individual
MRS. MARY KATHRYN OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
200 GLEAVES ST, SUITE A, MADISON, TN 37115-2176
(615) 851-7865
(615) 851-7866
Mailing address
200 GLEAVES ST, SUITE A, MADISON, TN 37115-2176
(615) 851-7865
(615) 851-7866
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
15587
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524067
—
TN
Enumeration date
03/08/2011
Last updated
08/07/2012
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