Healthcare Provider Details

I. General information

NPI: 1164641320
Provider Name (Legal Business Name): CHRISTOPHER E OLSON RNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E DAKOTA AVE
PIERRE SD
57501-3313
US

IV. Provider business mailing address

800 E DAKOTA AVE
PIERRE SD
57501-3313
US

V. Phone/Fax

Practice location:
  • Phone: 605-224-3407
  • Fax: 605-224-3443
Mailing address:
  • Phone: 605-224-3407
  • Fax: 605-224-3443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCR000587
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: