Provider Demographics
NPI:1588983423
Name:OLIVER, MEREDITH (CNA)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-2514
Mailing Address - Country:US
Mailing Address - Phone:443-418-5478
Mailing Address - Fax:410-727-1165
Practice Address - Street 1:834 WOODWARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-2514
Practice Address - Country:US
Practice Address - Phone:443-418-5478
Practice Address - Fax:410-727-1165
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00043603171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications