MEDICARE: KELLIE OLIVER ARNP

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	363LF0000X	Family Nurse Practitioner	APRN9313212	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760855183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLIE OLIVER ARNP

Provider Business Mailing Address
First Line	:	500 WINDERLEY PLACE
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-3801
Country	:	US
Telephone Number	:	407-875-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 ACACIA RD
Second Line	:
City	:	DEBARY
State	:	FL
Zip	:	32713-3801
Country	:	US
Telephone Number	:	386-956-8973
Fax Number	:

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

Provider Enumeration Date	:	11/06/2015
Last Update Date	:	02/10/2026

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Directions to “ KELLIE OLIVER ARNP” Practice Location

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