Provider Demographics
NPI:1609498658
Name:OLEWNICZAK, CHRISTIEN EILEEN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CHRISTIEN
Middle Name:EILEEN
Last Name:OLEWNICZAK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3592 WALDEN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1267
Mailing Address - Country:US
Mailing Address - Phone:716-572-5946
Mailing Address - Fax:
Practice Address - Street 1:3592 WALDEN AVE APT 3
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1267
Practice Address - Country:US
Practice Address - Phone:716-572-5946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345430-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily