Provider Demographics
NPI:1942199385
Name:GOERDT, OLIVIA CLAIRE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CLAIRE
Last Name:GOERDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 MOONCOIN WAY APT 10301
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6157
Mailing Address - Country:US
Mailing Address - Phone:412-398-0741
Mailing Address - Fax:
Practice Address - Street 1:205 CHARLES T WETHINGTON BUILDING
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program