Provider Demographics
NPI:1033425046
Name:OLSEN, CARI L (AUDIOLOGIST)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:L
Last Name:OLSEN
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-295-3326
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-295-3326
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002483A231H00000X
NC9861231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC30119577OtherSELECT HEALTH OF SC
NC7413721Medicaid
9911972OtherCIGNA
9001875OtherAETNA
SCQ414565874OtherMEDICARE
SC170KCOtherBLUE CROSS BLUE SHIELD
770107OtherWELLCARE
SCSAN100Medicaid
SCQ414565874OtherMEDICARE