| Doctor Name: | MS. STACIE LYNN OLSON |
| NPI Number: | 1669756755 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNP |
| License Number: | R26651 |
| Business Practice Address: | 1111 Gateway Dr. Ne East Grand Forks, MN - 56721 |
| Business Phone Number: | 2187930420 |
| Business Fax Number: | 2187930424 |
| Mailing Address: | 1111 Gateway Dr. Ne, EAST GRAND FORKS |
| State: | MN |
| Postal Code: | 56721 |
| Phone Number: | 2187930420 |
| Fax Number: | 2187930424 |
| NPI Enumeration Date: | 10/06/2011 |
| NPI Last Update Date: | 10/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R26651 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |