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NPI Code Detail

MEDICARE: MS. SUSAN KAY OLSON CNP/PAC

MEDICARE: MS. SUSAN KAY OLSON CNP/PAC
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
1363L00000XNurse PractitionerCP000049SD
2363A00000XPhysician Assistant0625SD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00331087OTHERSDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34994028OTHERSDWELLMARK
49237905OTHERSDDAKOTACARE

General Provider Information

NPI Number : 1295738789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN KAY OLSON CNP/PAC
Provider Business Mailing Address
First Line : PO BOX 1411
Second Line :
City : HURON
State : SD
Zip : 57350-1411
Country : US
Telephone Number : 605-352-8767
Fax Number : 605-352-8784
Provider Business Practice Location Address
First Line : 455 KANSAS AVE SE
Second Line :
City : HURON
State : SD
Zip : 57350-2522
Country : US
Telephone Number : 605-352-8767
Fax Number : 605-352-8784
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 11/03/2009

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