Individual
MRS. JEANINNE OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1993 ERRECART BLVD, ELKO, NV 89801-8334
(775) 753-1049
(775) 777-8494
Mailing address
1993 ERRECART BLVD, ELKO, NV 89801-8334
(775) 753-1049
(775) 777-8494
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109398
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN737Z
MEDICARE PTAN
FL
Enumeration date
06/13/2006
Last updated
07/21/2022
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