Provider Demographics
NPI:1821229154
Name:OLSEN, ABBY L (ANP-BC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:L
Last Name:OLSEN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:363 FREMONT ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3389
Mailing Address - Country:US
Mailing Address - Phone:269-969-6123
Mailing Address - Fax:269-969-6122
Practice Address - Street 1:363 FREMONT ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3389
Practice Address - Country:US
Practice Address - Phone:269-969-6123
Practice Address - Fax:269-969-6122
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2012-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704261671163WC1500X, 363LA2200X
MI207Q000000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704261671OtherSTATE LICENSE