Provider Demographics
NPI:1780672782
Name:OLSON, PATRICIA VIOLA (MS RNC WHNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:VIOLA
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS RNC WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 SWAN DR
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1072
Mailing Address - Country:US
Mailing Address - Phone:219-865-0340
Mailing Address - Fax:
Practice Address - Street 1:8645 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6222
Practice Address - Country:US
Practice Address - Phone:219-769-3500
Practice Address - Fax:319-791-0538
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001058A363LW0102X
IL363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71001058AOtherNP
IN28107644AOtherRN