Individual
KIM OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
24765 CROCKER BLVD, HARRISON TWP, MI 48045-1905
(586) 493-9753
(586) 493-9754
Mailing address
24765 CROCKER BLVD, HARRISON TWP, MI 48045-1905
(586) 493-9753
(586) 493-9754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704193706
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704193706
STATE OF MICHIGAN DEPT OF LICENSING AND REGULATORY AFFAIRS BOARD OF NURSING
MI
Enumeration date
04/15/2014
Last updated
04/15/2014
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