Provider Demographics
NPI:1801295571
Name:OLSON, JENNIFER LYNN (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HAFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:333 PINE RIDGE BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4102
Mailing Address - Country:US
Mailing Address - Phone:715-847-2121
Mailing Address - Fax:715-847-2614
Practice Address - Street 1:333 PINE RIDGE BLVD STE 317
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4102
Practice Address - Country:US
Practice Address - Phone:715-847-2121
Practice Address - Fax:715-847-2614
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5934-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily