Healthcare Provider Details

I. General information

NPI: 1437448131
Provider Name (Legal Business Name): EMILY A OLSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 DEERWOOD AVE
NEENAH WI
54956-7110
US

IV. Provider business mailing address

3 NEENAH CTR
NEENAH WI
54956-3070
US

V. Phone/Fax

Practice location:
  • Phone: 920-727-9982
  • Fax:
Mailing address:
  • Phone: 715-256-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60143
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: