Provider Demographics
NPI:1780060277
Name:STUDLEY, OLIVIA
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:STUDLEY
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 1:29 DEARBORN ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 DEARBORN ST
Practice Address - Street 2:UNIT 1
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2448
Practice Address - Country:US
Practice Address - Phone:619-985-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2267507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse