Healthcare Provider Details
I. General information
NPI: 1821935826
Provider Name (Legal Business Name): OLIVIA PALERMO
Entity Type: Individual
Gender:
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13120 E 19TH AVE
AURORA CO
80045-2567
US
IV. Provider business mailing address
34052 ALCAZAR DR APT A
DANA POINT CA
92629-6648
US
V. Phone/Fax
- Phone: 303-724-1812
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 95304065 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: