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General NPI Number Information
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NPI Number | 1538511654
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Entity Type | Individual
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Provider Name | KELLY OLIVIER
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 8700 GEORGIA AVE STE 400
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City | SILVER SPRING
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State | MD
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Zip | 20910-3605
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Country | US
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Telephone | 301-585-6049
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 GEORGIA AVE STE 400
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City | SILVER SPRING
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State | MD
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Zip | 20910-3605
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Country | US
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Telephone | 301-585-6049
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R200779
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License Number State | MD
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