Provider Demographics
NPI:1821430323
Name:OLSCHEWSKE, LISA (CD(DONA) CLC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:OLSCHEWSKE
Suffix:
Gender:F
Credentials:CD(DONA) CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 NAUTICAL WAY
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-9163
Mailing Address - Country:US
Mailing Address - Phone:904-806-3778
Mailing Address - Fax:
Practice Address - Street 1:640 NAUTICAL WAY
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-9163
Practice Address - Country:US
Practice Address - Phone:904-806-3778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula