Provider Demographics
NPI:1467813352
Name:NICHOLSON, OLIVEA
Entity Type:Individual
Prefix:MS
First Name:OLIVEA
Middle Name:
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:OLIVEA
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 E STERNE BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1026
Mailing Address - Country:US
Mailing Address - Phone:303-798-0074
Mailing Address - Fax:303-798-0139
Practice Address - Street 1:280 E STERNE BLVD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1026
Practice Address - Country:US
Practice Address - Phone:303-798-0074
Practice Address - Fax:303-798-0139
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23Y819373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist