Provider Demographics
NPI:1477962959
Name:OLSON, JANALEA S (RPH)
Entity Type:Individual
Prefix:
First Name:JANALEA
Middle Name:S
Last Name:OLSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 HWY 95
Mailing Address - Street 2:SUITE 256
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442
Mailing Address - Country:US
Mailing Address - Phone:928-763-7272
Mailing Address - Fax:928-758-9233
Practice Address - Street 1:2250 HWAY 95
Practice Address - Street 2:SUITE 256
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-9013
Practice Address - Country:US
Practice Address - Phone:928-763-7272
Practice Address - Fax:928-758-9233
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist