Healthcare Provider Details

I. General information

NPI: 1396865341
Provider Name (Legal Business Name): JULIA C OLSON RN AD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 ALAMEDA ST
NORMAN OK
73071-5229
US

IV. Provider business mailing address

909 ALAMEDA ST
NORMAN OK
73071-5229
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-3941
  • Fax: 405-573-3962
Mailing address:
  • Phone: 405-573-3941
  • Fax: 405-573-3962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberK4405029 40039265
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: