MEDICARE: OLIVIA GARRETT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WE0003X	Emergency Registered Nurse	28185325A	IN
2	363LF0000X	Family Nurse Practitioner	3016436	KY
3	363LF0000X	Family Nurse Practitioner	28185325A	IN
4	363LF0000X	Family Nurse Practitioner	71011528A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023781929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA GARRETT NP

Provider Business Mailing Address
First Line	:	4832 RICHMOND DR
Second Line	:
City	:	NEWBURGH
State	:	IN
Zip	:	47630-2142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 N GREEN RIVER RD STE 1
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2942
Country	:	US
Telephone Number	:	812-901-5770
Fax Number	:	877-748-1758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	12/11/2023

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Directions to “ OLIVIA GARRETT NP” Practice Location

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