Provider Demographics
NPI:1598209330
Name:COUCH, OLIVIA ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:ANN
Last Name:COUCH
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:801 NOBLE STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201
Mailing Address - Country:US
Mailing Address - Phone:256-770-4083
Mailing Address - Fax:256-405-4997
Practice Address - Street 1:801 NOBLE STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201
Practice Address - Country:US
Practice Address - Phone:256-770-4083
Practice Address - Fax:256-405-4997
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-113070363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health