Healthcare Provider Details

I. General information

NPI: 1881370039
Provider Name (Legal Business Name): OLIVIA MANDIC N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: OLIVIA SUZANNE PIERCE N.P

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 COOPER RD
CINCINNATI OH
45242-5613
US

IV. Provider business mailing address

4310 COOPER RD
CINCINNATI OH
45242-5613
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-9799
  • Fax: 513-246-9456
Mailing address:
  • Phone: 513-246-9799
  • Fax: 513-246-9456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0041684
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN269390
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1171952
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: