Healthcare Provider Details

I. General information

NPI: 1811703952
Provider Name (Legal Business Name): OLIVIA WILSON LIPKA MURPHY BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA WILSON LIPKA

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 OVERLAND AVE STE 370
SAN DIEGO CA
92123-1202
US

IV. Provider business mailing address

821 DAPHNE CT
CARLSBAD CA
92011-4701
US

V. Phone/Fax

Practice location:
  • Phone: 619-236-2191
  • Fax:
Mailing address:
  • Phone: 317-965-4893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number95394701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: