Individual
CLINT OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
1051 E 1150 N, OGDEN, UT 84404-7722
(801) 644-0793
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
6597936-4405
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/06/2019
Last updated
02/11/2020
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