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NPI Code Detail

MEDICARE: MRS. ALICE OLLIFF RN,BSN,PHN

MEDICARE: MRS. ALICE OLLIFF RN,BSN,PHN
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
1163WC1500XCommunity Health Registered Nurse403168CA

General Provider Information

NPI Number : 1306970645
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICE OLLIFF RN,BSN,PHN
Provider Business Mailing Address
First Line : 11030 CRYSTAL SPRINGS RD
Second Line :
City : SANTEE
State : CA
Zip : 92071-3110
Country : US
Telephone Number : 619-569-5969
Fax Number :
Provider Business Practice Location Address
First Line : 5202 UNIVERSITY AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-2268
Country : US
Telephone Number : 619-229-5409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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