Provider Demographics
NPI:1003539842
Name:ABUHL, OLIVIA (PA-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ABUHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3101 N CENTRAL AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2639
Mailing Address - Country:US
Mailing Address - Phone:602-230-7373
Mailing Address - Fax:602-257-8029
Practice Address - Street 1:235 W WESTERN AVE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1848
Practice Address - Country:US
Practice Address - Phone:602-230-7373
Practice Address - Fax:602-230-3086
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ9400363A00000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant