Healthcare Provider Details

I. General information

NPI: 1316931884
Provider Name (Legal Business Name): ANN OLEWNIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US

IV. Provider business mailing address

2333 N 7TH ST PO BOX 62
GRAND JUNCTION CO
81502-0062
US

V. Phone/Fax

Practice location:
  • Phone: 970-244-2273
  • Fax: 970-255-1809
Mailing address:
  • Phone: 970-244-2273
  • Fax: 970-255-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number32585
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: