Provider Demographics
NPI:1689474660
Name:VLASIN, OLIVIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:VLASIN
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27101 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-5241
Mailing Address - Country:US
Mailing Address - Phone:262-488-4428
Mailing Address - Fax:
Practice Address - Street 1:3109 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2935
Practice Address - Country:US
Practice Address - Phone:414-482-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22930-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist