Basic Information
Provider Information
NPI: 1043827397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FAIG
FirstName: OLIVIA
MiddleName: ISABELLA
NamePrefix:  
NameSuffix:  
Credential: APRN-CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHAEFER
OtherFirstName: OLIVIA
OtherMiddleName: ISABELLA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: APRN-CNP
OtherLastNameType: 1
Mailing Information
Address1: 3333 BURNET AVE # 6015
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136360800
FaxNumber: 5136364283
Practice Location
Address1: 3333 BURNET AVE. ML 6015
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136360800
FaxNumber: 5138030823
Other Information
ProviderEnumerationDate: 09/29/2020
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAPRN.CNP.0027636OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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