Provider Demographics
NPI:1235375544
Name:OLSON, DIXIE LEE (RN, GNP-BC)
Entity Type:Individual
Prefix:MS
First Name:DIXIE
Middle Name:LEE
Last Name:OLSON
Suffix:
Gender:F
Credentials:RN, GNP-BC
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Other - First Name:
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Mailing Address - Street 1:328 4TH ST SE APT 203
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-1795
Mailing Address - Country:US
Mailing Address - Phone:952-210-3655
Mailing Address - Fax:
Practice Address - Street 1:401 FINVOLD ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:WI
Practice Address - Zip Code:54028-9719
Practice Address - Country:US
Practice Address - Phone:715-600-0549
Practice Address - Fax:715-997-7044
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI248166363LG0600X
MNR 86139-1363LG0600X
MN2333363LG0600X
WI9267-33363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology