Healthcare Provider Details

I. General information

NPI: 1972586410
Provider Name (Legal Business Name): CHERYL-SUE OLMSTEAD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 VAN BUREN RD
CARIBOU ME
04736-3567
US

IV. Provider business mailing address

PO BOX 40
CARIBOU ME
04736-0040
US

V. Phone/Fax

Practice location:
  • Phone: 207-498-6921
  • Fax: 207-498-1697
Mailing address:
  • Phone: 207-498-2359
  • Fax: 207-498-3947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR029814
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: