Healthcare Provider Details

I. General information

NPI: 1902357148
Provider Name (Legal Business Name): ALISON L OLSON APRN, CNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISON L FISHER

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 SMITH AVE N
SAINT PAUL MN
55102-2387
US

IV. Provider business mailing address

5901 LINCOLN DR
EDINA MN
55436-1611
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6210
  • Fax: 651-220-7777
Mailing address:
  • Phone: 952-992-5691
  • Fax: 952-992-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number164584-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberCNP4997
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: