Provider Demographics
NPI:1073203519
Name:OLSON, KAYLA MARIE
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20653 STATE ROUTE 26
Mailing Address - Street 2:
Mailing Address - City:WINGETT RUN
Mailing Address - State:OH
Mailing Address - Zip Code:45789-9624
Mailing Address - Country:US
Mailing Address - Phone:740-516-5774
Mailing Address - Fax:
Practice Address - Street 1:20653 STATE ROUTE 26
Practice Address - Street 2:
Practice Address - City:WINGETT RUN
Practice Address - State:OH
Practice Address - Zip Code:45789-9624
Practice Address - Country:US
Practice Address - Phone:740-516-5774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide