Healthcare Provider Details

I. General information

NPI: 1497671911
Provider Name (Legal Business Name): GABRIELLE JANE OLIVERA BSN, RN, SNM, SWHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 SEAYS DR
DILLWYN VA
23936-3479
US

IV. Provider business mailing address

41 SEAYS DR
DILLWYN VA
23936-3479
US

V. Phone/Fax

Practice location:
  • Phone: 904-504-6923
  • Fax:
Mailing address:
  • Phone: 904-504-6923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001334282
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: