Provider Demographics
NPI:1487048914
Name:OLIVIER, AUDREY BILLEAUD (MD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:BILLEAUD
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AUDREY
Other - Middle Name:BILLEAUD
Other - Last Name:GLEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9049
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-9049
Mailing Address - Country:US
Mailing Address - Phone:033-415-4101
Mailing Address - Fax:303-741-5247
Practice Address - Street 1:101 ERIE PKWY STE 201C
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-4072
Practice Address - Country:US
Practice Address - Phone:303-415-5816
Practice Address - Fax:303-293-0625
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61194207Q00000X
390200000X
CODR.0067327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000197470Medicaid
SC611948Medicaid