Individual
TERESA MARIE OLIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 HOSPITAL PLZ, GRAFTON, WV 26354-1283
(304) 265-0400
Mailing address
1 HOSPITAL PLZ, GRAFTON, WV 26354-1283
(904) 494-6467
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
55751
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207026000
MEDICAID GROUP
WV
01
—
3019254
OHIO MEDICAID
OH
05
—
3810016709
—
WV
01
—
9333201
MEDICARE GROUP
WV
Enumeration date
01/19/2010
Last updated
03/13/2024
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