Healthcare Provider Details

I. General information

NPI: 1457271413
Provider Name (Legal Business Name): ALLYZA OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 OAKWOOD HILLS PKWY
EAU CLAIRE WI
54701-7698
US

IV. Provider business mailing address

3440 OAKWOOD HILLS PKWY
EAU CLAIRE WI
54701-7698
US

V. Phone/Fax

Practice location:
  • Phone: 715-214-2525
  • Fax: 715-214-2525
Mailing address:
  • Phone: 715-214-2525
  • Fax: 715-214-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number333884
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: