| Doctor Name: | CHARLES OLSEN |
| NPI Number: | 1053795518 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 20065 |
| Business Practice Address: | 307 Devonia St Harriman, TN - 377482008 |
| Business Phone Number: | 8658821164 |
| Business Fax Number: | |
| Mailing Address: | 240w Tyrone Rd, OAK RIDGE |
| State: | TN |
| Postal Code: | 378306517 |
| Phone Number: | 8654821076 |
| Fax Number: | 8654816179 |
| NPI Enumeration Date: | 07/15/2015 |
| NPI Last Update Date: | 07/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 20065 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |