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NPI Code Detail

MEDICARE: JESSENIA OLIVO ARNP-BC

MEDICARE: JESSENIA OLIVO ARNP-BC
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
1163W00000XRegistered NurseRN9425950FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerF407045NY

General Provider Information

NPI Number : 1609318435
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSENIA OLIVO ARNP-BC
Provider Business Mailing Address
First Line : 1309 COFFEEN AVE STE 1200
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-5777
Country : US
Telephone Number : 516-423-3234
Fax Number :
Provider Business Practice Location Address
First Line : 1309 COFFEEN AVE STE 1200
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-5777
Country : US
Telephone Number : 516-423-3234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 08/27/2025

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Directions to “ JESSENIA OLIVO ARNP-BC” Practice Location

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