Healthcare Provider Details

I. General information

NPI: 1447454145
Provider Name (Legal Business Name): RACHEL ANTOINETTE OLIVERIO DO,MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 W AGENCY RD
WEST BURLINGTON IA
52655-1659
US

IV. Provider business mailing address

1401 W AGENCY RD
WEST BURLINGTON IA
52655-1659
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4100
  • Fax:
Mailing address:
  • Phone: 319-768-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberH0064925
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4173
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number4173
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: