Provider Demographics
NPI:1356195697
Name:OLSON, ASHLEY LAUREN (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAUREN
Last Name:OLSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28 ANDOVER ST STE 1R
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4888
Mailing Address - Country:US
Mailing Address - Phone:978-475-9230
Mailing Address - Fax:
Practice Address - Street 1:28 ANDOVER ST STE 1R
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4888
Practice Address - Country:US
Practice Address - Phone:210-861-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant