KELLEY BROOKE OLSEN (NPI# 1891214466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891214466 |
| Entity Type | Individual |
| Full Name | KELLEY BROOKE OLSEN |
| Credential | CRNA |
| Practice Address |
1300 Anne St Nw Bemidji MN 56601-5103 |
| Mailing Address |
15228 Joes Lodge Dr Se Bemidji MN 56601-7920 |
| Practice Telephone | 2183335000 |
| Mailing Telephone | 2185562771 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2020-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 2104 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 203 4th St Nw, Bagley, MN 566218305 | 2186946501 |
| Street Address |
1300 ANNE ST NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922090901 | Marvin R Fetter | Orthopaedic Surgery | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2005-08-17 |
| 1679129555 | Ashley Marie Wavrin | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-08-15 |
| 1649824996 | Angela Halvorson | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-25 |
| 1114589348 | Rachel Marie Vesta | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-09 |
| 1407419419 | Ethan Axtman | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-04-16 |
| 1053895201 | Jarad Syrstad | Physical Therapist | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-23 |
| 1851874416 | Kimberly Miller | Physician Assistant | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-10 |
| 1780175752 | Billie Jo Dressing | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-05-24 |
| 1386142818 | Andrea May Lucca | Social Worker | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-30 |
| 1356859979 | Andrew William Rook | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801165592 | Jacob Bradley Stay | Nurse Anesthetist, Certified Registered | 10375 E Movil Lake Rd Ne, Bemidji, MN 56601-9786 | 2011-12-25 |
| 1447366422 | Arlon Bruce Eriksson | Nurse Anesthetist, Certified Registered | 1300 Anne St. Nw, Bemidji, MN 56601-5103 | 2006-08-22 |
| 1013905603 | Sandra J Kilde | Nurse Anesthetist, Certified Registered | 27040 County Road 9, Bemidji, MN 56601-5456 | 2005-10-09 |
| 1023400355 | Natalee Schultz | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2015-02-24 |
| 1063814739 | Matthew B Fjeld | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601 | 2014-09-24 |
| 1275955767 | Myles Brandt | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2014-01-17 |
| 1841531787 | Sheridan Anesthesia Services of Minnesota, PC | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2013-03-01 |
| 1225347792 | Keith Allen Nelson | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2010-10-01 |
| 1285708438 | Sanford Health of Northern Minnesota | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2006-11-20 |
| 1356446694 | Ronald W. Bardwell | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601 | 2006-09-13 |
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| 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.