Provider Demographics
NPI:1396166989
Name:OLIVER, ROXANNE MICHELLE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:MICHELLE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MS
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6424 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:OH
Mailing Address - Zip Code:43342-9510
Mailing Address - Country:US
Mailing Address - Phone:815-953-1900
Mailing Address - Fax:
Practice Address - Street 1:1728 MARION WALDO RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-7457
Practice Address - Country:US
Practice Address - Phone:740-389-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011135363LF0000X
OHCOA.18192-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily