Provider Demographics
NPI:1174030589
Name:BATCHELOR, OLIVIA MARCIA
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARCIA
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 GARDNER AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-5344
Mailing Address - Country:US
Mailing Address - Phone:786-290-1745
Mailing Address - Fax:239-491-9922
Practice Address - Street 1:1904 GARDNER AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-5344
Practice Address - Country:US
Practice Address - Phone:786-290-1745
Practice Address - Fax:239-491-9922
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906926376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator