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General NPI Number Information
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NPI Number | 1134049752
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Entity Type | Individual
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Provider Name | MELISSA R OLSON
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Gender | Female
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 204 2ND ST
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City | GRAY
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State | IA
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Zip | 50110-2310
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Country | US
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Telephone | 712-250-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 204 2ND ST
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City | GRAY
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State | IA
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Zip | 50110-2310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | P57444
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State | IA
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