Provider Demographics
NPI:1124302476
Name:LEON, OLIVIA ANN (RN)
Entity type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:ANN
Last Name:LEON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:OLIVIA
Other - Middle Name:ANN
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6411 N. ROBERT RD.
Mailing Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICK #22/SSO
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314
Mailing Address - Country:US
Mailing Address - Phone:928-759-4042
Mailing Address - Fax:928-759-4030
Practice Address - Street 1:6411 N. ROBERT RD.
Practice Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICK #22/SSO
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-759-4042
Practice Address - Fax:928-759-4030
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN169302163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool