Provider Demographics
NPI:1275129991
Name:CARSON, OLIVIA BELL (APRN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:BELL
Last Name:CARSON
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EDMOND RD
Mailing Address - Street 2:
Mailing Address - City:GRISWOLD
Mailing Address - State:CT
Mailing Address - Zip Code:06351-1511
Mailing Address - Country:US
Mailing Address - Phone:860-949-2291
Mailing Address - Fax:
Practice Address - Street 1:6 EDMOND RD
Practice Address - Street 2:
Practice Address - City:GRISWOLD
Practice Address - State:CT
Practice Address - Zip Code:06351-1511
Practice Address - Country:US
Practice Address - Phone:860-949-2291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily