Provider Demographics
NPI:1760761902
Name:OLSON, CHARLA RHEA (APN)
Entity Type:Individual
Prefix:MS
First Name:CHARLA
Middle Name:RHEA
Last Name:OLSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 DR. MARTIN LUTHER KING PKWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813
Mailing Address - Country:US
Mailing Address - Phone:423-587-1987
Mailing Address - Fax:423-587-9252
Practice Address - Street 1:220 DR. MARTIN LUTHER KING PKWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813
Practice Address - Country:US
Practice Address - Phone:423-587-1987
Practice Address - Fax:423-587-9252
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000016008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4188703OtherBCBS
TN1510583Medicaid