Healthcare Provider Details

I. General information

NPI: 1821420423
Provider Name (Legal Business Name): ANDREA OLIVEIRA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USA MEDDAC BAVARIA CMR 411, BLDG 700, ROSE BARRACKS
APO AE
09112-0038
US

IV. Provider business mailing address

14 MIRIJO RD
DANBURY CT
06811-3825
US

V. Phone/Fax

Practice location:
  • Phone: 499662834719
  • Fax:
Mailing address:
  • Phone: 203-797-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number085379
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: