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General NPI Number Information
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NPI Number | 1407455157
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Entity Type | Individual
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Provider Name | FAITH EMMA OLSON FNP
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Gender | Female
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 2550 WINDING RIVER DR UNIT C1
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City | BROOMFIELD
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State | CO
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Zip | 80023-6545
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Country | US
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Telephone | 727-745-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 WINDING RIVER DR UNIT C1
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City | BROOMFIELD
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State | CO
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Zip | 80023-6545
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Country | US
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Telephone | 172-745-2781
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0995633-NP
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License Number State | CO
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