Individual
MISS OLIVIA MARIE COUNTRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 E COUNTY LINE RD STE 302, GREENWOOD, IN 46143-1071
(317) 434-4637
Mailing address
111 NEW HAMPSHIRE AVE STE 2, PORTSMOUTH, NH 03801-2864
(330) 947-6021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10005371A
IN
363A00000X
Physician Assistant
Primary
—
IN
Other
Enumeration date
03/19/2026
Last updated
07/06/2026
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