Healthcare Provider Details

I. General information

NPI: 1770586398
Provider Name (Legal Business Name): EVELYN OUELLETTE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 CONSTITUTION AVE
OLEAN NY
14760-1840
US

IV. Provider business mailing address

2430 CONSTITUTION AVE
OLEAN NY
14760-1840
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-0700
  • Fax: 716-373-7270
Mailing address:
  • Phone: 716-373-0700
  • Fax: 716-373-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334898-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: