Provider Demographics
NPI:1588225304
Name:OLSTEN, CHARLOTTE (NP-C)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:OLSTEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2189 WILD DANCE TRL
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45434-5609
Mailing Address - Country:US
Mailing Address - Phone:317-213-0842
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner