Provider Demographics
NPI:1205898269
Name:OLSON, RONALD LEE (CRNA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEE
Last Name:OLSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-9173
Mailing Address - Country:US
Mailing Address - Phone:301-325-6306
Mailing Address - Fax:
Practice Address - Street 1:827 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-9173
Practice Address - Country:US
Practice Address - Phone:301-325-6306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1746367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered