Provider Demographics
NPI:1750162244
Name:OLSON, CARLEEN
Entity type:Individual
Prefix:
First Name:CARLEEN
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 31ST AVE E APT 24
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NORTH DAKOTA
Practice Address - Street 2:NURSING BLDG 430 OXFORD ST
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202
Practice Address - Country:US
Practice Address - Phone:701-777-4174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty