Provider Demographics
NPI:1679150692
Name:OLANO, JESSICA LYNNE (CERTIFIED NURSE MIDW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:OLANO
Suffix:
Gender:F
Credentials:CERTIFIED NURSE MIDW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:530 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3204
Mailing Address - Country:US
Mailing Address - Phone:602-422-9000
Mailing Address - Fax:602-556-5951
Practice Address - Street 1:35 N ESTRELLA PKWY
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4690
Practice Address - Country:US
Practice Address - Phone:623-846-7558
Practice Address - Fax:623-846-1674
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZCNM06958367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife