Provider Demographics
NPI:1093057408
Name:NESVIJSKI, OLGA (RN)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:NESVIJSKI
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 1:50 S COMMON ST APT 506
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4449
Mailing Address - Country:US
Mailing Address - Phone:978-810-1806
Mailing Address - Fax:
Practice Address - Street 1:50 S COMMON ST APT 506
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4449
Practice Address - Country:US
Practice Address - Phone:978-810-1806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258682163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse