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NPI Code Detail

MEDICARE: MARGARET ANN WOLLEN-OLSON FNP

MEDICARE: MARGARET ANN WOLLEN-OLSON FNP
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
1363LF0000XFamily Nurse Practitioner2007018587MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1366364OTHERAMERICAN NURSES CREDENTIALING CENTER
22007018587OTHERMOMISSOURI STATE BOARD OF NURSING
312818OTHERCABOARD OF REGISTERED NURSING

General Provider Information

NPI Number : 1831355809
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET ANN WOLLEN-OLSON FNP
Provider Business Mailing Address
First Line : 1616 INDUSTRIAL DR
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-1471
Country : US
Telephone Number : 573-636-2181
Fax Number :
Provider Business Practice Location Address
First Line : 1616 INDUSTRIAL DR
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-1471
Country : US
Telephone Number : 573-636-2181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2008
Last Update Date : 04/19/2010

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