Healthcare Provider Details

I. General information

NPI: 1699698621
Provider Name (Legal Business Name): OLIVIA HOTCHKISS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E 1400 N
LOGAN UT
84341-2691
US

IV. Provider business mailing address

3996 DEWEY RD
SHORTSVILLE NY
14548-9714
US

V. Phone/Fax

Practice location:
  • Phone: 435-915-4465
  • Fax:
Mailing address:
  • Phone: 585-348-0980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: