Provider Demographics
NPI:1366675993
Name:OLSON, BRENDA KAY (CRNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:OLSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 PLAZA DEL DIOS
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-3985
Mailing Address - Country:US
Mailing Address - Phone:702-339-7160
Mailing Address - Fax:954-923-1299
Practice Address - Street 1:2109 PLAZA DEL DIOS
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-3985
Practice Address - Country:US
Practice Address - Phone:702-339-7160
Practice Address - Fax:954-923-1299
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-083007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily