Provider Demographics
NPI:1174872220
Name:OLAIYA, EMMANUELLA NNENNA (CRNP)
Entity type:Individual
Prefix:
First Name:EMMANUELLA
Middle Name:NNENNA
Last Name:OLAIYA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 824804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4804
Mailing Address - Country:US
Mailing Address - Phone:302-421-4775
Mailing Address - Fax:302-421-4777
Practice Address - Street 1:701 N CLAYTON ST
Practice Address - Street 2:STE 505 MOB
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3165
Practice Address - Country:US
Practice Address - Phone:302-421-4775
Practice Address - Fax:302-421-4777
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0044198163WW0101X
PARN575222163WX0200X
PASP012353363LW0102X
DELH-0000204363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0200XNursing Service ProvidersRegistered NurseOncology