National Provider Identifier

Olivia Rose Johnson

Olivia Rose Johnson is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Rochester, NY and a listed phone number of (585) 442-8020.

NPI 1629820816Rochester, NYFamily Nurse Practitioner

Profile Overview

NPI
1629820816
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
April 02, 2024
Last Updated
August 09, 2024

Practice Location

  • 125 Lattimore RD Ste 258
  • Rochester, NY 14620-4155

Phone: (585) 442-8020

Mailing Address

  • 7276 Gillis RD
  • Victor, NY 14564-9541

Specialties

  • Family Nurse Practitioner (363LF0000X)
  • Registered Nurse (163W00000X)
Full Record
NPI
1629820816
Entity Type
Individual
Last Name
Johnson
First Name
Olivia
Middle Name
Rose
Mailing Street Address
7276 Gillis RD
Mailing City
Victor
Mailing State
NY
Mailing ZIP Code
14564-9541
Mailing Country
US
Mailing Phone
(716) 785-0659
Practice Street Address
125 Lattimore RD Ste 258
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14620-4155
Practice Country
US
Practice Phone
(585) 442-8020
Enumeration Date
April 02, 2024
Last Updated
August 09, 2024
Sex
Female
Sole Proprietor
No
Certification Date
August 08, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X), Registered Nurse (163W00000X)