Provider Demographics
NPI:1962695221
Name:OLIVER, KELLY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 TURKEYSAG TRL STE B
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2661
Mailing Address - Country:US
Mailing Address - Phone:434-589-7902
Mailing Address - Fax:434-589-7912
Practice Address - Street 1:194 TURKEYSAG TRL STE B
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-2661
Practice Address - Country:US
Practice Address - Phone:434-589-7902
Practice Address - Fax:434-589-7912
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist