Individual
DR. JACQUELINE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
10475 CENTURION PKWY N, SUITE 303, JACKSONVILLE, FL 32256-5003
(904) 399-0350
(904) 390-3502
Mailing address
10475 CENTURION PKWY N, SUITE 303, JACKSONVILLE, FL 32256-5003
(904) 399-0350
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BB346Z
MEDICARE PTAN
FL
Enumeration date
08/10/2006
Last updated
10/05/2010
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