Provider Demographics
NPI:1881466027
Name:OLCOTT, CHRISTINA GRACE (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:GRACE
Last Name:OLCOTT
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 CALENDAR BROOK RD
Mailing Address - Street 2:
Mailing Address - City:LYNDONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05851-9110
Mailing Address - Country:US
Mailing Address - Phone:802-535-0540
Mailing Address - Fax:
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1446
Practice Address - Country:US
Practice Address - Phone:603-747-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH093245-23363LP0808X
VT101.0136829363LP0808X
VT026.0112576163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse