MEDICARE: SARA M OLSON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	838	WI
2	363LF0000X	Family Nurse Practitioner	838	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265479299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA M OLSON NP

Provider Business Mailing Address
First Line	:	2660 PRAIRIE LAKE RD
Second Line	:
City	:	TOMAHAWK
State	:	WI
Zip	:	54487-8881
Country	:	US
Telephone Number	:	715-966-0855
Fax Number	:

Provider Business Practice Location Address
First Line	:	2660 PRAIRIE LAKE RD
Second Line	:
City	:	TOMAHAWK
State	:	WI
Zip	:	54487-8881
Country	:	US
Telephone Number	:	715-966-0855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	01/02/2025

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