Healthcare Provider Details

I. General information

NPI: 1679607055
Provider Name (Legal Business Name): RACHEL ELIZABETH OLSON RN, MS, CCRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 28TH ST SUITE 40
MINNEAPOLIS MN
55407-1139
US

IV. Provider business mailing address

920 E 28TH ST SUITE 40
MINNEAPOLIS MN
55407-1139
US

V. Phone/Fax

Practice location:
  • Phone: 612-863-3818
  • Fax: 612-863-2490
Mailing address:
  • Phone: 612-863-3818
  • Fax: 612-863-2490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR143479-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: