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General NPI Number Information
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NPI Number | 1801639091
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Entity Type | Individual
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Provider Name | OLIVIA DAVIS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2024
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 3000 N HALSTED ST STE 803
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City | CHICAGO
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State | IL
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Zip | 60657-6185
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Country | US
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Telephone | 312-376-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 179 CREEKSIDE GREEN DR
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City | COLUMBUS
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State | OH
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Zip | 43230-2880
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Country | US
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Telephone | 740-502-4035
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0036675
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN.456186
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.034936
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0102498-C-NP
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 041.603054
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License Number State | IL
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