Provider Demographics
NPI:1427597582
Name:OLSON, LINDA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:A
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:526 SANDY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6757
Mailing Address - Country:US
Mailing Address - Phone:314-853-5924
Mailing Address - Fax:
Practice Address - Street 1:15 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2904
Practice Address - Country:US
Practice Address - Phone:330-470-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145662164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse