Healthcare Provider Details
I. General information
NPI: 1548842016
Provider Name (Legal Business Name): TANYA SHENETA OLIVER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/24/2021
Last Update Date: 04/24/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4172 EGYPT CENTRAL RD
MEMPHIS TN
38128
US
IV. Provider business mailing address
4847 NAVY RD UNIT 1584
MILLINGTON TN
38083
US
V. Phone/Fax
- Phone: 901-857-7092
- Fax:
- Phone: 901-857-7092
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC2100X |
| Taxonomy | Continence Care Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD1100X |
| Taxonomy | Peritoneal Dialysis Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WE0900X |
| Taxonomy | Enterostomal Therapy Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0100X |
| Taxonomy | Gastroenterology Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0600X |
| Taxonomy | Gerontology Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0500X |
| Taxonomy | Infusion Therapy Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0600X |
| Taxonomy | Infection Control Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WN1003X |
| Taxonomy | Nutrition Support Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WN0300X |
| Taxonomy | Nephrology Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0000X |
| Taxonomy | Pain Management Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WU0100X |
| Taxonomy | Urology Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WM0705X |
| Taxonomy | Medical-Surgical Registered Nurse |
| License Number | 868787 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
