Healthcare Provider Details

I. General information

NPI: 1659288090
Provider Name (Legal Business Name): MARILYN OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 3RD ST
CAMBRIDGE IA
50046-1104
US

IV. Provider business mailing address

215 3RD ST
CAMBRIDGE IA
50046-1104
US

V. Phone/Fax

Practice location:
  • Phone: 515-451-7772
  • Fax:
Mailing address:
  • Phone: 515-451-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: