Provider Demographics
NPI:1548842016
Name:OLIVER, TANYA SHENETA (RN)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:SHENETA
Last Name:OLIVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4847 NAVY RD
Mailing Address - Street 2:UNIT 1584
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38083
Mailing Address - Country:US
Mailing Address - Phone:901-857-7092
Mailing Address - Fax:
Practice Address - Street 1:4172 EGYPT CENTRAL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128
Practice Address - Country:US
Practice Address - Phone:901-857-7092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS868787163WC2100X, 163WD1100X, 163WE0900X, 163WG0100X, 163WG0600X, 163WH1000X, 163WI0500X, 163WI0600X, 163WN1003X, 163WN0300X, 163WP0000X, 163WP0809X, 163WU0100X, 163WW0000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WU0100XNursing Service ProvidersRegistered NurseUrology
No163WW0000XNursing Service ProvidersRegistered NurseWound Care