Provider Demographics
NPI:1003657677
Name:SOBOJINSKI, OLIVIA KATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:KATHERINE
Last Name:SOBOJINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9886 RIVERS BEND DR
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-8358
Mailing Address - Country:US
Mailing Address - Phone:815-218-4324
Mailing Address - Fax:
Practice Address - Street 1:2055 W HOSPITAL DR STE 205
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7822
Practice Address - Country:US
Practice Address - Phone:520-575-6944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical