Healthcare Provider Details

I. General information

NPI: 1598633349
Provider Name (Legal Business Name): CAITLIN OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 FRANCE AVE S
EDINA MN
55435-2104
US

IV. Provider business mailing address

1500 IRVING ST STE 102
ALEXANDRIA MN
56308-0047
US

V. Phone/Fax

Practice location:
  • Phone: 952-848-5600
  • Fax:
Mailing address:
  • Phone: 320-391-4578
  • Fax: 320-763-2592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: