Provider Demographics
NPI:1922305143
Name:WOITA, OLIVIA SUE (NP-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:SUE
Last Name:WOITA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2211
Mailing Address - Country:US
Mailing Address - Phone:402-616-2257
Mailing Address - Fax:
Practice Address - Street 1:206 N 117TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2211
Practice Address - Country:US
Practice Address - Phone:402-616-2257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA100022363LF0000X
NE111221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily