Provider Demographics
NPI:1194945550
Name:OLIVE, ERMIN E (MS,RD)
Entity type:Individual
Prefix:MRS
First Name:ERMIN
Middle Name:E
Last Name:OLIVE
Suffix:
Gender:F
Credentials:MS,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8B-1 CROWN AND HAWK
Mailing Address - Street 2:PO BOX 4583
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803
Mailing Address - Country:US
Mailing Address - Phone:340-774-7352
Mailing Address - Fax:
Practice Address - Street 1:123 VITRACO PARK MALL
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-776-7966
Practice Address - Fax:340-774-1928
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered