Individual
TERRA MARIE OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 WRIGHT ST, ELKHORN, WI 53121-1932
(262) 325-6116
Mailing address
13 WRIGHT ST, ELKHORN, WI 53121-1932
(262) 325-6116
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311468-031
WI
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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