MEDICARE: MS. REBECCA ELIZABETH OLIVER RN/FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	622661	CA
2	363LF0000X	Family Nurse Practitioner	704354	TX
3	363LF0000X	Family Nurse Practitioner	16266	CA

General Provider Information

NPI Number	:	1063514198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA ELIZABETH OLIVER RN/FNP-C

Provider Business Mailing Address
First Line	:	6700 RIDGE TOP DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-3913
Country	:	US
Telephone Number	:	915-755-4412
Fax Number	:

Provider Business Practice Location Address
First Line	:	3706 RIVERA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-2505
Country	:	US
Telephone Number	:	915-533-7057
Fax Number	:	915-533-7197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	09/11/2025

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