Individual provider · NPI-1

Olivia Larussa Anderson, CRNP

Nurse Practitioner, Pediatrics · Birmingham, AL

NPI number1780341818
StatusActive
Last updated in NPPESSep 10, 2024

Details

NPI
1780341818
Entity type
Individual (NPI-1)
Name
Olivia Larussa Anderson
Credential
CRNP
Sex
Female
Sole proprietor
No
Enumeration date
Nov 23, 2021
Certification date
Sep 10, 2024
Last updated
Sep 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics1-166457ALYes

Other names

  • Olivia Childs Larussa (Former Name)

Practice location

1600 7th Ave S
Birmingham, AL 35233-1711

Phone 205-638-9100

Mailing address

1600 7th Ave S
Birmingham, AL 35233-1711

Phone 205-638-9583

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