Provider Demographics
NPI:1871108522
Name:OLSON, HUNTER (RN)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:OLSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 N 24TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-2791
Mailing Address - Country:US
Mailing Address - Phone:314-620-4995
Mailing Address - Fax:
Practice Address - Street 1:2004 N 24TH ST APT 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-2791
Practice Address - Country:US
Practice Address - Phone:314-620-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201908009RN163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical