MEDICARE: KATE OLSEN CRNA

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	367500000X	Certified Registered Nurse Anesthetist	9282498	FL
2	367500000X	Certified Registered Nurse Anesthetist	APRN9282498	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629415179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE OLSEN CRNA

Provider Business Mailing Address
First Line	:	1329 SW 16TH ST RM 2232
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1128
Country	:	US
Telephone Number	:	352-733-0485
Fax Number	:

Provider Business Practice Location Address
First Line	:	2337 SUMMERFIELD RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-5008
Country	:	US
Telephone Number	:	407-921-8589
Fax Number	:

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

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	01/19/2021

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Directions to “ KATE OLSEN CRNA” Practice Location

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