Provider Demographics
NPI:1427599083
Name:EDISON, OLIVIA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:EDISON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:NALULE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-5066
Mailing Address - Fax:614-293-9449
Practice Address - Street 1:300 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1280
Practice Address - Country:US
Practice Address - Phone:614-293-5066
Practice Address - Fax:614-293-9449
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032022363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner