Provider Demographics
NPI:1760070841
Name:OLSON, DENISE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:LAKE PRESTON
Mailing Address - State:SD
Mailing Address - Zip Code:57249-2116
Mailing Address - Country:US
Mailing Address - Phone:605-847-4484
Mailing Address - Fax:
Practice Address - Street 1:401 PRAIRIE AVE SW
Practice Address - Street 2:
Practice Address - City:DE SMET
Practice Address - State:SD
Practice Address - Zip Code:57231-2333
Practice Address - Country:US
Practice Address - Phone:605-854-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine