Provider Demographics
NPI:1922844257
Name:BAYNE, OLIVIA (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:BAYNE
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-2519
Mailing Address - Country:US
Mailing Address - Phone:479-394-1414
Mailing Address - Fax:
Practice Address - Street 1:1103 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2519
Practice Address - Country:US
Practice Address - Phone:479-394-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR229713363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner