Provider Demographics
NPI:1033871660
Name:FRICKE, OLIVIA LYNN (CNM, APRN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:LYNN
Last Name:FRICKE
Suffix:
Gender:F
Credentials:CNM, APRN
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:LYNN
Other - Last Name:WREFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, APRN
Mailing Address - Street 1:1919 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3747
Mailing Address - Country:US
Mailing Address - Phone:719-580-9134
Mailing Address - Fax:612-236-4745
Practice Address - Street 1:1919 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3747
Practice Address - Country:US
Practice Address - Phone:719-580-9134
Practice Address - Fax:612-236-4745
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN472367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife