Provider Demographics
NPI:1598586430
Name:OLDS, NICOLE VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:VICTORIA
Last Name:OLDS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 7TH ST S STE 575
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4743
Mailing Address - Country:US
Mailing Address - Phone:727-553-7100
Mailing Address - Fax:727-553-7198
Practice Address - Street 1:601 7TH ST S STE 575
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4743
Practice Address - Country:US
Practice Address - Phone:727-553-7100
Practice Address - Fax:727-553-7198
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035529363L00000X
FLAPRN11035529363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner