Provider Demographics
NPI:1255146841
Name:OLSEN, ANGELA (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 GIVHANS LOOP
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-2444
Mailing Address - Country:US
Mailing Address - Phone:843-806-8388
Mailing Address - Fax:
Practice Address - Street 1:122 OKATIE CENTER BLVD N STE 100
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-3782
Practice Address - Country:US
Practice Address - Phone:843-806-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily