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NPI Code Detail

MEDICARE: OLENA ANDRIYIVNA STOUT FNP

MEDICARE: OLENA ANDRIYIVNA STOUT FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner354443NY

General Provider Information

NPI Number : 1306684725
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLENA ANDRIYIVNA STOUT FNP
Provider Business Mailing Address
First Line : 245 AVERY LN
Second Line :
City : ROME
State : NY
Zip : 13441-4237
Country : US
Telephone Number : 315-337-1200
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N JAMES ST
Second Line :
City : ROME
State : NY
Zip : 13440-2844
Country : US
Telephone Number : 315-338-7184
Fax Number : 315-339-1975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 01/09/2026

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Directions to “ OLENA ANDRIYIVNA STOUT FNP” Practice Location

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