Provider Demographics
NPI:1477522100
Name:OLSON, AMY JO (RN, APNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:OLSON
Suffix:
Gender:F
Credentials:RN, APNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 S 46TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8153
Mailing Address - Country:US
Mailing Address - Phone:414-758-0019
Mailing Address - Fax:
Practice Address - Street 1:6580 S 46TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8153
Practice Address - Country:US
Practice Address - Phone:414-421-0276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI144471-030163W00000X
WI5660-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse