MEDICARE: OLIVIA GRACE ANDREWS

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	390200000X	Student in an Organized Health Care Education/Training Program		GA

General Provider Information

NPI Number	:	1326991852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA GRACE ANDREWS

Provider Business Mailing Address
First Line	:	1290 MOUNTAIN IVEY CT
Second Line	:
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-5537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 MOUNTAIN IVEY CT
Second Line	:
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-5537
Country	:	US
Telephone Number	:	770-597-0051
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ OLIVIA GRACE ANDREWS ” Practice Location

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