Provider Demographics
NPI:1548739014
Name:OLSON, KATIE J (CRNA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:J
Last Name:OLSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JO RYGH
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:3320 LOUISIANA AVE S APT 205
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4129
Mailing Address - Country:US
Mailing Address - Phone:641-590-4901
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR196904-3163W00000X
MN2275367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse