Individual
OLIVIA WHEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2874 N CARSON ST STE 120, CARSON CITY, NV 89706-1681
(775) 445-5193
Mailing address
1114 MODOC WAY, SOUTH LAKE TAHOE, CA 96150-5248
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2921
NV
Other
Enumeration date
01/03/2022
Last updated
12/30/2024
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