Provider Demographics
NPI:1457153363
Name:PICCIONE, OLIVIA J (RN)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:J
Last Name:PICCIONE
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 N MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-4312
Mailing Address - Country:US
Mailing Address - Phone:800-275-8777
Mailing Address - Fax:
Practice Address - Street 1:218 N MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-4312
Practice Address - Country:US
Practice Address - Phone:800-275-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1086628-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse