Provider Demographics
NPI:1104541457
Name:ALVESTEFFER, OLIVIA LYNNE (EMT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:LYNNE
Last Name:ALVESTEFFER
Suffix:
Gender:F
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NIELSEN RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-1662
Mailing Address - Country:US
Mailing Address - Phone:231-740-3927
Mailing Address - Fax:
Practice Address - Street 1:2026 PACKARD RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1057
Practice Address - Country:US
Practice Address - Phone:989-773-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2008793146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic