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Individual

EMMA CRILL OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(919) 274-2558
Mailing address
828 SENECA PL, CHARLOTTE, NC 28210-2924
(919) 274-2558

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07235
NC
363AM0700X
Medical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010-07235
NORTH CAROLINA MEDICAL LICENSE
NC
01
1142669
NCCPA CERTIFICATION
Enumeration date
02/18/2017
Last updated
01/14/2021
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