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General NPI Number Information
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NPI Number | 1740551738
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Entity Type | Organization
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Legal Business Name | OLSON MEDICAL, LLC
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 43 HILL TOP DR
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City | JEFFERSON
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State | GA
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Zip | 30549-1261
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Country | US
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Telephone | 770-653-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 43 HILL TOP DR
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City | JEFFERSON
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State | GA
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Zip | 30549-1261
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Country | US
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Telephone | 770-653-5211
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SHERYL A OLSON
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Credential | FNP-BC
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Telephone | 770-653-5211
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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 | 143016NP
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License Number State | GA
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