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NPI Code Detail

MEDICARE: LESLIE OLIVIER

MEDICARE:   LESLIE  OLIVIER
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
1363LF0000XFamily Nurse Practitioner0017142708VA

General Provider Information

NPI Number : 1932569837
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE OLIVIER
Provider Business Mailing Address
First Line : 814 KEMPSVILLE RD
Second Line : STE 104
City : NORFOLK
State : VA
Zip : 23502-4001
Country : US
Telephone Number : 757-455-8887
Fax Number :
Provider Business Practice Location Address
First Line : 814 KEMPSVILLE RD
Second Line : SUITE 104
City : NORFOLK
State : VA
Zip : 23502-4001
Country : US
Telephone Number : 757-455-8887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2016
Last Update Date : 04/29/2016

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Directions to “ LESLIE OLIVIER ” Practice Location

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