Healthcare Provider Details

I. General information

NPI: 1083534523
Provider Name (Legal Business Name): KRISTIN ANN OLSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1530 2ND AVE
CUMBERLAND WI
54829-9060
US

IV. Provider business mailing address

1530 2ND AVE
CUMBERLAND WI
54829-9060
US

V. Phone/Fax

Practice location:
  • Phone: 715-822-8123
  • Fax:
Mailing address:
  • Phone: 715-822-5123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number116853
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: