Healthcare Provider Details

I. General information

NPI: 1891638318
Provider Name (Legal Business Name): MADISON BLAIR OLSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FRIST CT
COLUMBUS GA
31909-3578
US

IV. Provider business mailing address

1054 GREEN RIDGE RD
CATAULA GA
31804-3276
US

V. Phone/Fax

Practice location:
  • Phone: 706-494-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP295677
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: