Healthcare Provider Details

I. General information

NPI: 1891657789
Provider Name (Legal Business Name): OLIDIA HOSPICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2025
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 MARKET PLACE DR
EDEN PRAIRIE MN
55344-3636
US

IV. Provider business mailing address

7530 MARKET PLACE DR
EDEN PRAIRIE MN
55344-3636
US

V. Phone/Fax

Practice location:
  • Phone: 763-298-3001
  • Fax: 763-634-5997
Mailing address:
  • Phone: 763-298-3001
  • Fax: 763-634-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: OLIVIER NKWONKAM
Title or Position: OWNER AND CEO
Credential:
Phone: 612-567-7780