Individual
JILL OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 524-2161
(715) 524-8164
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3792
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750510103
—
WI
Enumeration date
07/07/2009
Last updated
08/31/2011
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