Provider Demographics
NPI:1669061305
Name:OLSON, MEREDITH SUZANNE (RN)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:SUZANNE
Last Name:OLSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:SUZANNE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:9811 DELRAY DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9811 DELRAY DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5615
Practice Address - Country:US
Practice Address - Phone:407-435-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9552814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse