Healthcare Provider Details

I. General information

NPI: 1366318735
Provider Name (Legal Business Name): COURTNEY H OLIVAS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 VOLVO PKWY STE 100
CHESAPEAKE VA
23320-3341
US

IV. Provider business mailing address

860 OMNI BLVD STE 401
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-389-5370
  • Fax: 757-389-5381
Mailing address:
  • Phone: 757-232-8860
  • Fax: 757-232-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0001317430
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: