Individual
OLIVIA A RELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 477-1558
Mailing address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28230407A
IN
363L00000X
Nurse Practitioner
Primary
71011647A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28230407A
RN LICENSE
IN
Enumeration date
07/01/2021
Last updated
10/01/2021
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