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General NPI Number Information
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NPI Number | 1316844046
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Entity Type | Individual
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Provider Name | OLIVIA LEE NIGHTINGALE NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/26/2026
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Last Update Date | 10/26/2026
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Provider Practice Location Address
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Address Line | 3601 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6712
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Country | US
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Telephone | 248-898-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 6532 LEET ST
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City | ALLEN PARK
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State | MI
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Zip | 48101-2582
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Country | US
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Telephone | 313-529-6602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 4704353544
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License Number State | MI
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