Provider Demographics
NPI:1831856699
Name:MCFADDEN, OLIVIA NOELLE PRATHER (MSN, APRN)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:NOELLE PRATHER
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:NOELLE
Other - Last Name:PRATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:800 ROSE ST # C261
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-7001
Mailing Address - Country:US
Mailing Address - Phone:859-825-8328
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-6154
Practice Address - Fax:859-323-3499
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016639363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics