Doctor Name: | BRANDICE OLSEN |
NPI Number: | 1104196351 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 201140700RN |
Business Practice Address: | 4100 Lake Otis Pkwy Suite 222 Anchorage, AK - 995085229 |
Business Phone Number: | 9075506100 |
Business Fax Number: | 9075506268 |
Mailing Address: | 14700 28th Ave N, Suite 20 PLYMOUTH |
State: | MN |
Postal Code: | 554474835 |
Phone Number: | 7635593779 |
Fax Number: | 7634503986 |
NPI Enumeration Date: | 01/05/2012 |
NPI Last Update Date: | 02/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 201140700RN |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |