Provider Demographics
NPI:1093967739
Name:OLSON, DONNA (ARNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LOVELAND BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980
Mailing Address - Country:US
Mailing Address - Phone:941-624-7200
Mailing Address - Fax:941-624-7274
Practice Address - Street 1:1100 LOVELAND BOULEVARD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980
Practice Address - Country:US
Practice Address - Phone:941-624-7200
Practice Address - Fax:941-624-7274
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1726302363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner