Healthcare Provider Details

I. General information

NPI: 1649370040
Provider Name (Legal Business Name): DAVID K OLIVER RN, CNN, CRNI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE BLDG 9, 1ST FLOOR, NEPHROLOGY CLINIC
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

14217 NORTHWYN DRIVE
SILVER SPRING MD
20904
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-7812
  • Fax: 301-400-1040
Mailing address:
  • Phone: 301-236-9881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License NumberR075503
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: