Provider Demographics
NPI:1457033771
Name:JUNE, OLIVIA G (PA-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:G
Last Name:JUNE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1 KINGSTON COLLECTION WAY APT 352
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-3118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 CHURCH HILL RD STE 1
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:ME
Practice Address - Zip Code:04263-3418
Practice Address - Country:US
Practice Address - Phone:207-524-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2024-05-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant