1801866959 NPI number — CHRISTINE M. OLSON R.N. CN/P

Table of content: CHRISTINE M. OLSON R.N. CN/P (NPI 1801866959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801866959 NPI number — CHRISTINE M. OLSON R.N. CN/P

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLSON
Provider First Name:
CHRISTINE
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.N. CN/P
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801866959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 9TH ST SE
Provider Second Line Business Mailing Address:
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
Provider Business Mailing Address City Name:
LONG PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56347-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-732-2141
Provider Business Mailing Address Fax Number:
320-732-6913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 9TH ST SE
Provider Second Line Business Practice Location Address:
CENTRACARE HEALTH SYSTEM - LONG PRAIRIE
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-2141
Provider Business Practice Location Address Fax Number:
320-732-6913
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R135593-2 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HP33256 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 44F42OL . This is a "BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: A017 . This is a "CHAMPUS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0106754 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1149740 . This is a "AMERICA'S PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 814647100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1027460 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 151712D277 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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