Individual
MS. LISA JANE OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
361 E 1200 S STE 201, OREM, UT 84058-6904
(801) 224-3014
Mailing address
396 E 60 S, AMERICAN FORK, UT 84003-3835
(801) 302-2017
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
345768-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
345768-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
U002 802665
—
UT
05
—
U003 666
—
UT
05
—
U006 107030993101
—
UT
Enumeration date
12/20/2005
Last updated
12/02/2022
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