Provider Demographics
NPI:1710662655
Name:OLSON, ASHLEY (PA(ASCP))
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:PA(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16433 VANE ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1669
Mailing Address - Country:US
Mailing Address - Phone:402-319-2833
Mailing Address - Fax:
Practice Address - Street 1:16433 VANE ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1669
Practice Address - Country:US
Practice Address - Phone:402-319-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2322246Q00000X
NY000288-01207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology