Olsen, Amanda S

Olsen, Amanda S is an individual health care provider with primary practice located at 2200 Dickinson Rd Unit 17B , De Pere WI 54115-4070. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Olsen, Amanda S can be contacted via phone (920) 965-1234.

Contact Information

Primary practice address
2200 Dickinson Rd Unit 17B De Pere WI 54115-4070
Phone: (920) 965-1234
Fax: (920) 965-1232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA4138 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3281-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3281-23 Wisconsin

Profile Details

NPI number 1407154354
LBN Legal business name Olsen, Amanda S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2011
Last updated Apr 10th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407154354 NPPES
Wisconsin Other 3281-23 WISCONSIN PA LICENSE
Wisconsin MEDICAID 100037410 WISCONSIN PA LICENSE
Wisconsin Other PA4138 WISCONSIN PA LICENSE

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