Provider Demographics
NPI:1720787286
Name:KALNINS, OLIVIA A (NP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:A
Last Name:KALNINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:A
Other - Last Name:CROWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5832 MONTICELLO WAY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1509
Mailing Address - Country:US
Mailing Address - Phone:608-397-3508
Mailing Address - Fax:
Practice Address - Street 1:5832 MONTICELLO WAY
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-1509
Practice Address - Country:US
Practice Address - Phone:608-397-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI196000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner