Provider Demographics
NPI:1235338252
Name:OLSEN, SHEILA ANN (FNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-5122
Mailing Address - Country:US
Mailing Address - Phone:865-262-9210
Mailing Address - Fax:865-262-9211
Practice Address - Street 1:806 NAVAJO DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5122
Practice Address - Country:US
Practice Address - Phone:865-262-9210
Practice Address - Fax:865-262-9211
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4179733OtherBCBS
TN1506254Medicaid
TN33414311Medicare PIN