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General NPI Number Information
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NPI Number | 1760143085
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Entity Type | Individual
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Provider Name | OLIVIA M FAGIN
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Gender | Female
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Dates
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Enumeration Date | 01/08/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 555 RACE ST
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City | CINCINNATI
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State | OH
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Zip | 45202-2347
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Country | US
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Telephone | 855-699-6937
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 ELM HILL PIKE
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City | NASHVILLE
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State | TN
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Zip | 37214-3108
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Country | US
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Telephone | 615-425-4200
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 074.0134313
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN007782
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | D2229
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN-0010942
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 276301
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD.08944
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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