Healthcare Provider Details

I. General information

NPI: 1205612439
Provider Name (Legal Business Name): OLIVIA VALENTINA ZICARI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 LOS ALTOS PKWY
SPARKS NV
89436-7708
US

IV. Provider business mailing address

1155 MILL ST # MCM14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-5000
  • Fax: 775-982-3900
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-5496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number868232
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: