Provider Demographics
NPI:1851343107
Name:OLSON, KRISTINE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2997 PRINCETON PIKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3270
Mailing Address - Country:US
Mailing Address - Phone:609-771-0700
Mailing Address - Fax:609-771-0800
Practice Address - Street 1:2997 PRINCETON PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3270
Practice Address - Country:US
Practice Address - Phone:609-771-0700
Practice Address - Fax:609-771-0800
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR05591700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7944004Medicaid
NJ7944004Medicaid
NJ027107M5NMedicare PIN