Healthcare Provider Details

I. General information

NPI: 1700704632
Provider Name (Legal Business Name): HEIDI OLSON MSN, RN, CPN, SANE-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NURSING SCIENCES BUILDING
UNIVERSITY PARK PA
16802
US

IV. Provider business mailing address

201 NURSING SCIENCES BUILDING
UNIVERSITY PARK PA
16802
US

V. Phone/Fax

Practice location:
  • Phone: 815-680-8910
  • Fax:
Mailing address:
  • Phone: 815-680-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number2014016041
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: