Provider Demographics
NPI:1760400444
Name:OLSEN, JANICE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ANN
Last Name:OLSEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 FLOYD CURL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-615-6505
Mailing Address - Fax:210-615-1321
Practice Address - Street 1:7950 FLOYD CURL DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-615-6505
Practice Address - Fax:210-615-1321
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX556882367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
8N9942OtherBCBS
TX110785601Medicaid
S06742Medicare UPIN
TX800014MMedicare PIN