Provider Demographics
NPI:1730559436
Name:OLAUGHLIN, TRISH ELLEN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TRISH
Middle Name:ELLEN
Last Name:OLAUGHLIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14825 N OUTER 40 RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2152
Mailing Address - Country:US
Mailing Address - Phone:314-336-2555
Mailing Address - Fax:
Practice Address - Street 1:14825 N. OUTER 40 RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:314-336-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO141823163WX0800X
MOF1015167363LF0000X
MO2015039037363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner