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General NPI Number Information
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NPI Number | 1144652975
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Entity Type | Individual
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Provider Name | JOSEPHINE KIMBERLY OLSEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2013
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1251 RUDDER LN
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City | OSPREY
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State | FL
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Zip | 34229-9104
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Country | US
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Telephone | 206-660-5094
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Fax |
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Provider Business Mailing Address
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Address Line | 1251 RUDDER LN
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City | OSPREY
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State | FL
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Zip | 34229-9104
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Country | US
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Telephone | 206-660-5094
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS12480
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License Number State | FL
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