MEDICARE: OLIVIA COLLINS 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
1	363LF0000X	Family Nurse Practitioner	RN2362381	MA

General Provider Information

NPI Number	:	1801631676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA COLLINS FNP

Provider Business Mailing Address
First Line	:	130 CHESTNUT HILL AVE
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-4731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 CHESTNUT HILL AVE
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-4731
Country	:	US
Telephone Number	:	781-715-6608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2024
Last Update Date	:	06/25/2024

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Directions to “ OLIVIA COLLINS FNP” Practice Location

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