Provider Demographics
NPI:1962063651
Name:OLOO, CAROLINE A (MSN FNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:OLOO
Suffix:
Gender:F
Credentials:MSN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 JASON DR
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-1558
Mailing Address - Country:US
Mailing Address - Phone:512-731-5002
Mailing Address - Fax:
Practice Address - Street 1:1554 JASON DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-1558
Practice Address - Country:US
Practice Address - Phone:512-731-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00928400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty