Krystle Lacole Oliver
Nurse Practitioner in Minneapolis, MN. Individual provider (NPI-1).
NPI number1417543406
StatusActive
Last updated in NPPESDec 19, 2020
Details
- NPI
- 1417543406
- Entity type
- Individual (NPI-1)
- Name
- Krystle Lacole Oliver
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 15, 2020
- Certification date
- Dec 19, 2020
- Last updated
- Dec 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 28734 | TN | Yes |
Practice location
100 Washington Ave SMinneapolis, MN 55401-2110
Phone 901-337-6920
Mailing address
100 Washington Ave SMinneapolis, MN 55401-2110
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