Provider Demographics
NPI:1669809000
Name:GALUSTIAN, CAROLINE OLIVEIRA (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:OLIVEIRA
Last Name:GALUSTIAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:OLIVEIRA
Other - Last Name:DOS SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3569 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-5443
Mailing Address - Country:US
Mailing Address - Phone:216-281-8945
Mailing Address - Fax:216-281-9565
Practice Address - Street 1:3569 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-5443
Practice Address - Country:US
Practice Address - Phone:216-281-8945
Practice Address - Fax:216-281-9565
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23485363LF0000X
OHCOA 18300-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily