Provider Demographics
NPI:1184685851
Name:OLSON, MARSHA C (NP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:C
Last Name:OLSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL RD STE 3B
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2253
Mailing Address - Country:US
Mailing Address - Phone:978-534-3179
Mailing Address - Fax:978-840-3161
Practice Address - Street 1:100 HOSPITAL RD STE 3B
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-534-3179
Practice Address - Fax:978-840-3161
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133753363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0321800Medicaid
MA0321800Medicaid
MANP4097Medicare PIN