Provider Demographics
NPI:1417712712
Name:HAMELS, OLIVIA (LPN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HAMELS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 HOBBLEBUSH LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:NY
Mailing Address - Zip Code:14085-9603
Mailing Address - Country:US
Mailing Address - Phone:716-848-9871
Mailing Address - Fax:
Practice Address - Street 1:500 SENECA ST STE 610
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-1963
Practice Address - Country:US
Practice Address - Phone:716-881-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345986-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse