Provider Demographics
NPI:1063663250
Name:OLSON, RITA RUST (RN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:RUST
Last Name:OLSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1552 UNIVERSITY AVE
Mailing Address - Street 2:ROOM 201E
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53726-4084
Mailing Address - Country:US
Mailing Address - Phone:608-265-6551
Mailing Address - Fax:608-262-9160
Practice Address - Street 1:1552 UNIVERSITY AVE
Practice Address - Street 2:ROOM 201E
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53726-4084
Practice Address - Country:US
Practice Address - Phone:608-265-6551
Practice Address - Fax:608-262-9160
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65889-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse