Healthcare Provider Details

I. General information

NPI: 1518094259
Provider Name (Legal Business Name): DOROTHEA JUNE OLSON REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 74TH AVE. NE
FT. TOTTEN ND
58335
US

IV. Provider business mailing address

PO BOX 415
DEVILS LAKE ND
58301-0415
US

V. Phone/Fax

Practice location:
  • Phone: 701-766-1600
  • Fax: 701-766-1626
Mailing address:
  • Phone: 701-662-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR27823
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberR27823
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: