MR. JONATHAN DEFOREST OLSON


Address: 30 W 22nd St, #204, Minneapolis, MN 55404-2428
Phone: 6123455261

MR. JONATHAN DEFOREST OLSON (NPI# 1487937892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487937892
Entity Type Individual
Full Name MR. JONATHAN DEFOREST OLSON
Other Name MS. JANE DENISE OLSON
Credential CNP
Practice Address 30 W 22nd St
#204
Minneapolis
MN 55404-2428
Practice Telephone 6123455261
Mailing Telephone 6123455261
Enumeration Date 2011-09-21
Last Update Date 2015-10-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
CNP0170 MN Physician Assistants & Advanced Practice Nursing Providers

Other Providers JONATHAN OLSON

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Office Location

Street Address 30 W 22ND ST
#204
City MINNEAPOLIS
State MN
Zip Code 55404-2428

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City MINNEAPOLIS
Zip Code 55404

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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