Individual
MS. LEANNA RAE OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., C.M.T.
Contact information
Practice address
1500 N. KICKAPOO, SUITE #4, SHAWNEE, OK 74804
(405) 214-7700
Mailing address
12 TRENTON CIR, MCLOUD, OK 74851-9512
(405) 964-5378
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0035490
OK
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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