MEDICARE: ERICA ANNE OLSON RDN

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1366770059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA ANNE OLSON RDN

Provider Business Mailing Address
First Line	:	7008 E FISH LAKE RD
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2832
Country	:	US
Telephone Number	:	303-868-8285
Fax Number	:

Provider Business Practice Location Address
First Line	:	7008 E FISH LAKE RD
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2832
Country	:	US
Telephone Number	:	303-868-8285
Fax Number	:

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

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	09/02/2025

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