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General NPI Number Information
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NPI Number | 1023088333
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Entity Type | Individual
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Provider Name | LAURA L. OLIVER PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 3401 BRANDYWINE PKWY STE 101
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City | WILMINGTON
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State | DE
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Zip | 19803-1554
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Country | US
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Telephone | 302-633-3555
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Fax | 302-479-1559
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Provider Business Mailing Address
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Address Line | 1941 LIMESTONE RD STE 101
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City | WILMINGTON
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State | DE
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Zip | 19808-5408
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Country | US
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Telephone | 302-633-3555
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Fax | 302-633-3559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C5-0000188
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0000188
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License Number State | DE
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