Individual
KELLY LYNN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1622 RANDY LN, MADISON, WI 53704-2045
(608) 220-0029
Mailing address
1622 RANDY LN, MADISON, WI 53704-2045
(608) 220-0029
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
099709
WI
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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