Healthcare Provider Details

I. General information

NPI: 1124884721
Provider Name (Legal Business Name): PAYTON ELIZABETH OLSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 S 70TH ST STE 110
LINCOLN NE
68516-4276
US

IV. Provider business mailing address

4501 S 70TH ST STE 110
LINCOLN NE
68516-4276
US

V. Phone/Fax

Practice location:
  • Phone: 402-937-1101
  • Fax: 402-937-1151
Mailing address:
  • Phone: 402-937-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113935
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number113935
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: