Provider Demographics
NPI:1376431239
Name:DE OLIVEIRA, RENATA CALASANS PORTUGAL (FNP)
Entity type:Individual
Prefix:MRS
First Name:RENATA
Middle Name:CALASANS PORTUGAL
Last Name:DE OLIVEIRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10551-0065
Mailing Address - Country:US
Mailing Address - Phone:786-518-8142
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 65
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10551-0065
Practice Address - Country:US
Practice Address - Phone:786-518-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF05250561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily