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NPI Code Detail

MEDICARE: OLIVIA NURU

MEDICARE: OLIVIA NURU
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1255982302
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA NURU
Provider Business Mailing Address
First Line : 3135 MARTHA STREET
Second Line :
City : SAVANNAH
State : GA
Zip : 31404
Country : US
Telephone Number : 912-341-9162
Fax Number :
Provider Business Practice Location Address
First Line : 8382 BAYMEADOWS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-4447
Country : US
Telephone Number : 904-755-0646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2019
Last Update Date : 09/20/2019

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Directions to “ OLIVIA NURU ” Practice Location

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