Provider Demographics
NPI:1578209391
Name:NAGY, OLIVIA JADE (PA)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JADE
Last Name:NAGY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1850 TOWN CENTER PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3300
Mailing Address - Country:US
Mailing Address - Phone:703-810-5202
Mailing Address - Fax:
Practice Address - Street 1:1850 TOWN CENTER PKWY STE 400
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3300
Practice Address - Country:US
Practice Address - Phone:559-320-0531
Practice Address - Fax:559-320-0539
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X, 363A00000X
CA61738363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant