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IVELISSE OLIVENCIA-SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2555 COURT DR STE 200, GASTONIA, NC 28054-2178
(704) 867-2141
(704) 867-2308
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
218300
CT
363L00000X
Nurse Practitioner
Primary
5003363
NC
363L00000X
Nurse Practitioner
79066
ID
363LA2100X
Acute Care Nurse Practitioner
5003363
NC

Other

Enumeration date
06/26/2007
Last updated
01/19/2026
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