Individual
KERRY OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
3244 51ST ST S, FARGO, ND 58104-7179
(701) 356-0062
(701) 356-5412
Mailing address
3244 51ST ST S, FARGO, ND 58104-7179
(701) 356-0062
(701) 356-5412
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102218
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401878
MEDICA
MN
05
—
660047600
—
MN
01
—
961S6OL
BCBS
MN
01
—
HP34809
HEALTH PARTNERS
MN
Enumeration date
02/15/2007
Last updated
08/20/2025
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