Provider Demographics
NPI:1659333169
Name:OLSON, APRIL M (PA-C)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:M
Last Name:OLSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7064 SPRINGHILL CIR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2615
Mailing Address - Country:US
Mailing Address - Phone:952-946-9777
Mailing Address - Fax:952-946-9888
Practice Address - Street 1:8100 W 78TH ST
Practice Address - Street 2:SUITE 225
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2516
Practice Address - Country:US
Practice Address - Phone:952-946-9777
Practice Address - Fax:952-946-9888
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN9892363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6825650Medicaid
NE46030609213Medicaid
IA0506345Medicaid
SDP64433Medicare UPIN
SD6825650Medicaid
SDS42481Medicare PIN