Provider Demographics
NPI:1205427069
Name:NEAU, OLIVIA CAMILLE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CAMILLE
Last Name:NEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7915 COUNTY ROAD H
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-4478
Mailing Address - Country:US
Mailing Address - Phone:262-744-9011
Mailing Address - Fax:
Practice Address - Street 1:318 N ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149-1334
Practice Address - Country:US
Practice Address - Phone:262-363-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI254057-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health