Provider Demographics
NPI:1871141358
Name:OLESON, KATHLEEN (PCNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:OLESON
Suffix:
Gender:F
Credentials:PCNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7202 GLEN FOREST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3780
Mailing Address - Country:US
Mailing Address - Phone:804-673-2024
Mailing Address - Fax:804-200-6229
Practice Address - Street 1:8007 DISCOVERY DR STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-8605
Practice Address - Country:US
Practice Address - Phone:804-287-3000
Practice Address - Fax:804-673-2731
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2024-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024177852363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health