Provider Demographics
NPI:1003832049
Name:OLSON, NANCY DIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:DIAN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1409
Mailing Address - Country:US
Mailing Address - Phone:203-785-1898
Mailing Address - Fax:203-281-3707
Practice Address - Street 1:47 TRUMBULL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1004
Practice Address - Country:US
Practice Address - Phone:203-785-1898
Practice Address - Fax:203-281-3707
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0300702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT308830Medicare UPIN