Individual
LAUREL OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7404 5TH AVE, BROOKLYN, NY 11209-2704
(718) 439-5111
Mailing address
968 60TH ST APT 210, BROOKLYN, NY 11219-4857
(612) 385-8908
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
641891
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
2018077032
NY
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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