Healthcare Provider Details

I. General information

NPI: 1306562574
Provider Name (Legal Business Name): OLIVIA BROWN NOLTE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: OLIVIA CATHERINE BROWN APRN

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

1216 TATES CREEK RD
LEXINGTON KY
40502-2209
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5956
  • Fax: 859-323-1080
Mailing address:
  • Phone: 859-333-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3018677
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number1153867
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: