Provider Demographics
NPI:1215600143
Name:BEARD, OLIVIA DALAO-BAGATELAS (DNP)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:DALAO-BAGATELAS
Last Name:BEARD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5050 POPLAR AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38157-0800
Mailing Address - Country:US
Mailing Address - Phone:901-276-2662
Mailing Address - Fax:901-274-2033
Practice Address - Street 1:5050 POPLAR AVE STE 800
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38157-0800
Practice Address - Country:US
Practice Address - Phone:901-276-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30037363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care