Provider Demographics
NPI:1346397643
Name:OLSON, DEBORAH LYNN (LPC, RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 FOXBRIAR TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0399
Mailing Address - Country:US
Mailing Address - Phone:704-598-3783
Mailing Address - Fax:704-598-8043
Practice Address - Street 1:5031 FOXBRIAR TRL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0399
Practice Address - Country:US
Practice Address - Phone:704-598-3783
Practice Address - Fax:704-598-8043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70176163W00000X
NC2676101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2676OtherL.P.C.
NC1022EOtherBCBS PROVIDER ID
NC70176OtherREGISTERED NURSE