Healthcare Provider Details

I. General information

NPI: 1205237419
Provider Name (Legal Business Name): LYNNETTE OLRICK-BIELINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2014
Last Update Date: 09/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 REGENT ST
MADISON WI
53715-1248
US

IV. Provider business mailing address

9 WYNBROOK CIR
MADISON WI
53704-6486
US

V. Phone/Fax

Practice location:
  • Phone: 608-282-2050
  • Fax:
Mailing address:
  • Phone: 608-695-4272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX1100X
TaxonomyOphthalmic Registered Nurse
License Number105366-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: