Provider Demographics
NPI:1881804789
Name:OLSON, JULIE ILENE (RN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ILENE
Last Name:OLSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 LOCKHORN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-1200
Mailing Address - Country:US
Mailing Address - Phone:262-335-2789
Mailing Address - Fax:
Practice Address - Street 1:2360 LOCKHORN CIR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1200
Practice Address - Country:US
Practice Address - Phone:262-335-2789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health