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NPI Code Detail

MEDICARE: ELLEN OLSON CPNP

MEDICARE: ELLEN OLSON CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerRN125237GA

General Provider Information

NPI Number : 1013953124
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN OLSON CPNP
Provider Business Mailing Address
First Line : 2220 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-785-1200
Fax Number : 404-785-6288
Provider Business Practice Location Address
First Line : 2220 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-785-1200
Fax Number : 404-785-6288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 10/09/2024

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