Healthcare Provider Details

I. General information

NPI: 1932661865
Provider Name (Legal Business Name): OLIVIA LEE WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DOWNWOOD CIR NW STE 220
ATLANTA GA
30327-1611
US

IV. Provider business mailing address

3200 DOWNWOOD CIR NW STE 200
ATLANTA GA
30327-1611
US

V. Phone/Fax

Practice location:
  • Phone: 404-312-3696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN310079
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-157891
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN-310079
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: