Provider Demographics
NPI:1871010066
Name:OLSON, ALICIA MAY (APN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MAY
Last Name:OLSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MAY
Other - Last Name:BERGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:627 24 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1277
Mailing Address - Country:US
Mailing Address - Phone:970-462-7126
Mailing Address - Fax:970-433-7624
Practice Address - Street 1:627 24 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1277
Practice Address - Country:US
Practice Address - Phone:970-462-7126
Practice Address - Fax:970-433-7624
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993434-NP363LP0808X, 363LP0808X
CORXN.0103062-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health