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General NPI Number Information
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NPI Number | 1174253652
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH HEALTH CARE SERVICES PLLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 6160 SW HIGHWAY 200 STE 110-513
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City | OCALA
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State | FL
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Zip | 34476-8307
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Country | US
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Telephone | 260-226-7848
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Fax | 260-233-6054
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Provider Business Mailing Address
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Address Line | 9458 LOOKOUT POINT DR
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City | LAINGSBURG
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State | MI
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Zip | 48848-8783
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Country | US
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Telephone | 517-410-8347
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACY M MEITLER
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Credential | AGPCNP-C
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Telephone | 517-410-8347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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