Provider Demographics
NPI:1033886437
Name:LOUIS, OLGINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:OLGINE
Middle Name:
Last Name:LOUIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1356 W GLEN OAK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-3950
Mailing Address - Country:US
Mailing Address - Phone:561-808-9248
Mailing Address - Fax:
Practice Address - Street 1:1356 W GLEN OAK RD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-3950
Practice Address - Country:US
Practice Address - Phone:561-808-9248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9481632163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty