Provider Demographics
NPI:1871266189
Name:GALLUCCI, OLIVIA CLAIRE (RN)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:CLAIRE
Last Name:GALLUCCI
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 1:1741 POTTERY AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2507
Mailing Address - Country:US
Mailing Address - Phone:253-310-1448
Mailing Address - Fax:
Practice Address - Street 1:1741 POTTERY AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2507
Practice Address - Country:US
Practice Address - Phone:253-310-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60893930163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse