Provider Demographics
NPI:1720350135
Name:OLSON, AMELIA ROSS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:ROSS
Last Name:OLSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WOOD RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21402-1257
Mailing Address - Country:US
Mailing Address - Phone:410-293-4378
Mailing Address - Fax:
Practice Address - Street 1:250 WOOD RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21402-1257
Practice Address - Country:US
Practice Address - Phone:410-293-4378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant