Individual
DAVID C OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4998 S OREGON TRAIL WAY, BOISE, ID 83716-7139
(507) 649-0755
Mailing address
4998 S OREGON TRAIL WAY, BOISE, ID 83716-7139
(507) 649-0755
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
252654
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
71642
ID
Other
Enumeration date
06/01/2021
Last updated
06/19/2023
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