Provider Demographics
NPI:1649773771
Name:FRINK, OLIVIA ROBIN (RN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROBIN
Last Name:FRINK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9547
Mailing Address - Country:US
Mailing Address - Phone:585-733-0142
Mailing Address - Fax:
Practice Address - Street 1:700 BAILEY RD
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9105
Practice Address - Country:US
Practice Address - Phone:585-733-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309636163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse