Provider Demographics
NPI:1164798427
Name:OLSEN, AIMEE JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:JEAN
Last Name:OLSEN
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 1:601 NW 5TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2963
Mailing Address - Country:US
Mailing Address - Phone:218-824-0615
Mailing Address - Fax:218-824-0611
Practice Address - Street 1:601 NW 5TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2963
Practice Address - Country:US
Practice Address - Phone:218-824-0615
Practice Address - Fax:218-824-0611
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1967919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse