Provider Demographics
NPI:1629577085
Name:OLSON, BRIANNA DEE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:DEE
Last Name:OLSON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:MISS
Other - First Name:BRIANNA
Other - Middle Name:DEE
Other - Last Name:HURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 E HOWARD ST STE 230
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-4203
Mailing Address - Country:US
Mailing Address - Phone:218-721-6350
Mailing Address - Fax:
Practice Address - Street 1:302 E HOWARD ST STE 230
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-4203
Practice Address - Country:US
Practice Address - Phone:218-721-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN728040183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician