KA OLIVER INC. NPI 1558863373

NPI Information

NPI: 1558863373
Provider Name: KA OLIVER INC.

Doing Business As: OZARK MOUNTAIN HEALTH AND WELLNESS

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
3810 N FRONT ST STE 11
FAYETTEVILLE, AR
ZIP 72703
Phone: (479) 387-4920
Get Directions

KA OLIVER INC. is a family nurse practitioner in Fayetteville, AR. KA OLIVER INC. NPI is 1558863373. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ozark Mountain Health And Wellness.

The provider's business location address is:

3810 N FRONT ST STE 11
FAYETTEVILLE, AR
ZIP 72703-217
Phone: (479) 387-4920

The provider's authorized official is Kelley Oliver .
The authorized official title is President and has the following contact phone number (479) 387-4920.

The enumeration date for this NPI number is 3/7/2018 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	A004049	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	206672758	MEDICAID	ARKANSAS
2	5AQ83	OTHER	ARKANSAS	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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