Provider Demographics
NPI:1164278537
Name:JOSE, OLIVIA REID (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:REID
Last Name:JOSE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 CYPRESS GREEN DR STE 403
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-5517
Mailing Address - Country:US
Mailing Address - Phone:904-257-3232
Mailing Address - Fax:
Practice Address - Street 1:9050 CYPRESS GREEN DR STE 403
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5517
Practice Address - Country:US
Practice Address - Phone:904-257-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily