Basic Information
Provider Information
NPI: 1801855143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLSHINSKI
FirstName: PHILIP
MiddleName: T
NamePrefix:  
NameSuffix:  
Credential: F.N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 WHITE OAK ST
Address2:  
City: ASHEBORO
State: NC
PostalCode: 272034710
CountryCode: US
TelephoneNumber: 3366251360
FaxNumber: 3366251360
Practice Location
Address1: 608 W ACADEMY ST
Address2:  
City: RANDLEMAN
State: NC
PostalCode: 273179748
CountryCode: US
TelephoneNumber: 3364951001
FaxNumber: 3364951001
Other Information
ProviderEnumerationDate: 03/23/2006
LastUpdateDate: 05/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X200774NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home