Reagan Eliza Oliver
Individual provider Active NPI Athletic Trainer · Marianna, FL
NPI 1992207302 · NPPES record last updated Mar 1, 2018
Key facts
- NPI
- 1992207302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 5472 Marble CT
Marianna, FL 32446-8050 - Phone
- (850) 573-8669
- NPI assigned
- Mar 1, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
5472 Marble CT
Marianna, FL 32446-8050
Mailing address
5472 Marble CT
Marianna, FL 32446-8050
Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.