Provider Demographics
NPI:1386234292
Name:OLIVER, QUINCA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:QUINCA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 N 126TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1961
Mailing Address - Country:US
Mailing Address - Phone:417-408-9342
Mailing Address - Fax:
Practice Address - Street 1:5111 N 126TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1961
Practice Address - Country:US
Practice Address - Phone:417-408-9342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy