Doctor Name: | KATE LYNN OLSON |
NPI Number: | 1063443679 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | |
Business Practice Address: | 150 W High St Morris, IL - 604501463 |
Business Phone Number: | 8159422932 |
Business Fax Number: | |
Mailing Address: | Po Box 66973, Slot 303125 CHICAGO |
State: | IL |
Postal Code: | 606660973 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |