Provider Demographics
NPI:1164641320
Name:OLSON, CHRISTOPHER E (RNA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:OLSON
Suffix:
Gender:M
Credentials:RNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-3313
Mailing Address - Country:US
Mailing Address - Phone:605-224-3407
Mailing Address - Fax:605-224-3443
Practice Address - Street 1:800 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3313
Practice Address - Country:US
Practice Address - Phone:605-224-3407
Practice Address - Fax:605-224-3443
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCR000587367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5754192Medicaid
SD4994299OtherBLUE CROSS
SD4994299OtherBLUE CROSS