Healthcare Provider Details

I. General information

NPI: 1730998246
Provider Name (Legal Business Name): CAROLYN ANN SEIFERMANN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN ANN OLSON DNP

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

4801 VETERANS DR
SAINT CLOUD MN
56303-2015
US

V. Phone/Fax

Practice location:
  • Phone: 320-252-1670
  • Fax: 320-255-6423
Mailing address:
  • Phone: 320-252-1670
  • Fax: 320-255-6423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number1229631
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1229631
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number20030447
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1229631
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: