Provider Demographics
NPI:1245229988
Name:OLMSTEAD, ELAINE MCGRANE (RN PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:MCGRANE
Last Name:OLMSTEAD
Suffix:
Gender:F
Credentials:RN PMHCNS-BC
Other - Prefix:MISS
Other - First Name:ELAINE
Other - Middle Name:LINDA
Other - Last Name:MCGRANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN MS CS
Mailing Address - Street 1:18 KINSLEY RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2808
Mailing Address - Country:US
Mailing Address - Phone:978-263-4320
Mailing Address - Fax:
Practice Address - Street 1:532 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3415
Practice Address - Country:US
Practice Address - Phone:978-263-0439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-16
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158892364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724651 OR 612861OtherTUFTS
MAPN0170OtherBC/BS
MA1245229988OtherUNITED BEHAVIORAL HEALTH
MAS98108Medicare UPIN
MAOL-NS0334Medicare ID - Type Unspecified