Individual
STACEY OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
16301 FISHHAWK BLVD STE 101, LITHIA, FL 33547-4157
(813) 681-3800
Mailing address
6524 BRIDGECREST DR, LITHIA, FL 33547-4863
(915) 328-5708
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
9430789
FL
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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