Healthcare Provider Details

I. General information

NPI: 1689859431
Provider Name (Legal Business Name): KATHRYN MARIE OLSEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 NE 5TH AVE UNIT B
DELRAY BEACH FL
33483-5532
US

IV. Provider business mailing address

393 NE 5TH AVE UNIT B
DELRAY BEACH FL
33483-5532
US

V. Phone/Fax

Practice location:
  • Phone: 561-270-0003
  • Fax:
Mailing address:
  • Phone: 561-270-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number129515
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number62900
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number47527
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD17635
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number04-37071
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27784
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: