Provider Demographics
NPI:1255589883
Name:OLSON, SARA ANN (PA-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:OZOLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9320 GRAND CORDERA PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924
Mailing Address - Country:US
Mailing Address - Phone:719-282-6337
Mailing Address - Fax:719-282-0532
Practice Address - Street 1:9320 GRAND CORDERA PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924
Practice Address - Country:US
Practice Address - Phone:719-282-6337
Practice Address - Fax:719-282-0532
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2661363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical