Healthcare Provider Details

I. General information

NPI: 1891095311
Provider Name (Legal Business Name): KRISTINA HELENE OLFSON F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA HELENE OLFSON-BAUER R.N.

II. Dates (important events)

Enumeration Date: 10/31/2010
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23795 WR HOLMAN HWY
MONTEREY CA
93940-5903
US

IV. Provider business mailing address

1167 CHAPARRAL RD
PEBBLE BEACH CA
93953-3146
US

V. Phone/Fax

Practice location:
  • Phone: 831-915-4924
  • Fax:
Mailing address:
  • Phone: 831-915-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: