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Individual

OLIVER ELLIOTT OLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN-NP

Contact information

Practice address
3707 CHAMBERLAIN LN STE 101, LOUISVILLE, KY 40241-2091
(502) 472-5657
Mailing address
3707 CHAMBERLAIN LN STE 101, LOUISVILLE, KY 40241-2091
(502) 472-5657

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1117485
KY
163W00000X
Registered Nurse
95063617
CA
363L00000X
Nurse Practitioner
Primary
3007504
KY
363LF0000X
Family Nurse Practitioner
95002557
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100211250
KY
Enumeration date
07/12/2012
Last updated
04/08/2016
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