Provider Demographics
NPI:1497214134
Name:TODD, AFRICA OLYMPIA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:AFRICA
Middle Name:OLYMPIA
Last Name:TODD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36868-1045
Mailing Address - Country:US
Mailing Address - Phone:334-291-5255
Mailing Address - Fax:877-395-0710
Practice Address - Street 1:1810 STADIUM DR STE 210
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3179
Practice Address - Country:US
Practice Address - Phone:334-291-5255
Practice Address - Fax:877-395-0710
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099436163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice