Provider Demographics
NPI:1144555707
Name:OLSON, TERRY LIN (RN, CNS)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:LIN
Last Name:OLSON
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Gender:F
Credentials:RN, CNS
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Mailing Address - Street 1:4601 DALE RD
Mailing Address - Street 2:ICU ROOM 2312
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9718
Mailing Address - Country:US
Mailing Address - Phone:209-735-7615
Mailing Address - Fax:209-735-7603
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:ICU ROOM 2312
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-7615
Practice Address - Fax:209-735-7603
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA351941163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine