Provider Demographics
NPI:1366286767
Name:DUROCHER-DUCATTE, OLIVIA THERESE (NP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:THERESE
Last Name:DUROCHER-DUCATTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 STATE ROUTE 3 # 1
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6562
Mailing Address - Country:US
Mailing Address - Phone:518-566-0672
Mailing Address - Fax:
Practice Address - Street 1:675 STATE ROUTE 3 # 1
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6562
Practice Address - Country:US
Practice Address - Phone:518-566-0672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily