Provider Demographics
NPI:1740804145
Name:PAUKEN, OLIVIA JEAN (DPT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JEAN
Last Name:PAUKEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-373-7116
Practice Address - Street 1:514 SAINT JAMES AVE UNIT G
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2767
Practice Address - Country:US
Practice Address - Phone:843-642-8660
Practice Address - Fax:843-642-8661
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018555225100000X
SC11208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist