Provider Demographics
NPI:1386143717
Name:OLIVER, ANDREW FREEMAN (NP-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:FREEMAN
Last Name:OLIVER
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MILLWOOD CIR STE F
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6304
Mailing Address - Country:US
Mailing Address - Phone:501-803-2620
Mailing Address - Fax:501-803-2300
Practice Address - Street 1:501 MILLWOOD CIR STE F
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6304
Practice Address - Country:US
Practice Address - Phone:501-803-2620
Practice Address - Fax:501-803-2300
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARF01181426363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care