Healthcare Provider Details

I. General information

NPI: 1801254859
Provider Name (Legal Business Name): OLENA LIBERTY APRN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLENA PYLYPENKO

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 08/01/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MEDICAL CENTER PARKWAY KENNEBEC ANESTHESIA ASSOCIAT SUITE 201
AUGUSTA ME
04330
US

IV. Provider business mailing address

35 MEDICAL CENTER PARKWAY SUITE 201
AUGUSTA ME
04330
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-1959
  • Fax: 207-430-4007
Mailing address:
  • Phone: 207-622-1959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA163033
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: