Provider Demographics
NPI:1235642661
Name:OLSEN, CHRISTOPHER (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:OLSEN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1554
Mailing Address - Country:US
Mailing Address - Phone:402-917-5065
Mailing Address - Fax:
Practice Address - Street 1:611 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1554
Practice Address - Country:US
Practice Address - Phone:402-917-5065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112566163W00000X
IAH157790363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse