Provider Demographics
NPI:1306462551
Name:OLIVER, LILLIAN W (RN, MSN)
Entity type:Individual
Prefix:MS
First Name:LILLIAN
Middle Name:W
Last Name:OLIVER
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 DRUMLIN FIELD WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1466
Mailing Address - Country:US
Mailing Address - Phone:515-991-0473
Mailing Address - Fax:
Practice Address - Street 1:5606 DRUMLIN FIELD WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1466
Practice Address - Country:US
Practice Address - Phone:515-991-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility