Individual
LUCKRICIA OLIVACCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1150 PROFESSIONAL CT, SUITE P, HAGERSTOWN, MD 21740-4100
(301) 665-9696
(240) 420-5715
Mailing address
11350 MCCORMICK RD, EXECUTIVE PLAZA 1, SUITE 501, HUNT VALLEY, MD 21031-1002
(301) 669-9696
(240) 420-5715
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0005876
MD
Other
Enumeration date
09/01/2015
Last updated
03/07/2022
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