Healthcare Provider Details

I. General information

NPI: 1932056777
Provider Name (Legal Business Name): OLIVIA POLLART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 FOXHUNT DR
BEAR DE
19701-2538
US

IV. Provider business mailing address

2147 CHRISTIAN ST UNIT 4
PHILADELPHIA PA
19146-2295
US

V. Phone/Fax

Practice location:
  • Phone: 302-836-2864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberL1-0074694
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: