Individual
LISA LYNN OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
17410 BANYAN RD, SHAFER, MN 55074-9675
(651) 829-5416
Mailing address
PO BOX 77, LINDSTROM, MN 55045-0077
(651) 829-5416
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L040235-2
MN
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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