OLSEN, KATHRYN MARIE (MD)

Provider Demographics

• NPI: 1689859431
• Name: OLSEN, KATHRYN MARIE (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: KATHRYN
• Middle Name: MARIE
• Last Name: OLSEN
• Gender: F
• Credentials: MD
• Mailing Address - Street 1: 10700 E GEDDES AVE
• Mailing Address - Street 2: SUITE 200
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3800
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 10700 E GEDDES AVE
• Practice Address - Street 2: SUITE 200
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80112-3800
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2007-12-28
• Last Update Date: 2017-04-07

Provider Licenses

State	License ID	Taxonomies
NC	129515	2085R0202X
CO	47527	2085R0202X
NE	27784	2085R0202X
KS	04-37071	2085R0202X
HI	MD17635	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
HI	0000367219	Other	RIA HMSA
WY	1689859431	Medicaid
NE	10026277600	Medicaid
NE	10026277700	Medicaid
KS	200631250A	Medicaid
NM	42939861	Medicaid
NE	10026277500	Medicaid
UT	1689859431	Medicaid
CO	69354391	Medicaid
NE	10025709000	Medicaid
NE	10026277400	Medicaid
NE	10026277800	Medicaid
NE	84089712600	Medicaid
OK	200530630A	Medicaid
NE	10026277300	Medicaid
MT	1689859431	Medicaid
AZ	483252	Medicaid
NE	84059792913	Medicaid
KS	200631250A	Medicaid
OK	200530630A	Medicaid
NE	10026277500	Medicaid
NE	10026277800	Medicaid
NE	10025709000	Medicaid
KS	111257073	Medicare PIN
CO	500346YQPG	Medicare PIN
CO	335168YQN9	Medicare PIN
NE	10026277400	Medicaid
NM	42939861	Medicaid
NE	NA2517016	Medicare PIN
NE	P01319316	Medicare PIN
KS	KA3249017	Medicare PIN
NE	NA1215084	Medicare PIN
HI	0000367219	Other	RIA HMSA