MEDICARE: MARLYS OLOFSON NP

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	163WW0101X	Ambulatory Women's Health Care Registered Nurse	81428	CO
2	163WW0101X	Ambulatory Women's Health Care Registered Nurse	724164	TX

General Provider Information

NPI Number	:	1710180484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLYS OLOFSON NP

Provider Business Mailing Address
First Line	:	12403 MOSSY BARK TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18810 HWY 290 E STE 101
Second Line	:
City	:	ELGIN
State	:	TX
Zip	:	78621-2107
Country	:	US
Telephone Number	:	512-445-4800
Fax Number	:

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	11/26/2014

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Directions to “ MARLYS OLOFSON NP” Practice Location

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