NPI | 1093908766 |
---|---|
Former Name | JANE ANN OLSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15456) |
Additional Taxonomies | 261QM1102X Clinic/Center, Military Outpatient Operational (Transportable) Component (Licence: HI APRN-967) |
261QM2500X Clinic/Center, Medical Specialty (Licence: CA 376865) | |
363LF0000X Nurse Practitioner, Family (Licence: HI APRN-967) | |
Enumeration Date | 2007-08-24 |
Last Update Date | 2014-01-06 |