MEDICARE: MS. LISA OLSON PHYSICIAN ASSISTANT

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
1	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	085.003393	IL

General Provider Information

NPI Number	:	1336128081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA OLSON PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	512 KIRKLAND AVE
Second Line	:	ALGOMA
City	:	ALGOMA
State	:	WI
Zip	:	54201-1075
Country	:	US
Telephone Number	:	262-758-1078
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 FREMONT ST
Second Line	:	ALGOMA
City	:	ALGOMA
State	:	WI
Zip	:	54201
Country	:	US
Telephone Number	:	920-487-3676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	01/07/2009

Similar Medicare Providers

1215910690 — ALGOMA MEDICAL CENTER
Practice Location Address:

1510 FREMONT ST
ALGOMA, WI
54201-1948

Practice Phone: 920-487-5511
Practice Fax: 920-487-2668

1295710515 — DR. JOHN EDWARD GORZ OD
Practice Location Address:

1021 JEFFERSON ST
ALGOMA, WI
54201-1737

Practice Phone: 920-487-2020
Practice Fax: 920-487-5022

1033194261 — TINA M SCHMIDT PA
Practice Location Address:

1510 FREMONT ST
ALGOMA, WI
54201-1948

Practice Phone: 920-487-3676
Practice Fax:

1609838473 — BELLIN MEMORIAL HOSPITAL INC
Practice Location Address:

831 PARKER ST
ALGOMA, WI
54201-1948

Practice Phone: 920-487-3676
Practice Fax:

1447291331 — KAY K SECREST DC
Practice Location Address:

316 STEELE ST
ALGOMA, WI
54201-1265

Practice Phone: 920-487-9909
Practice Fax: 877-898-0965

1568496784 — AURORA PHARMACY INC
Practice Location Address:

801 JEFFERSON ST
ALGOMA, WI
54201-1733

Practice Phone: 920-487-2887
Practice Fax: 920-487-3139

Directions to “ MS. LISA OLSON PHYSICIAN ASSISTANT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.