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:
Health care specialties
| Specialty | Code | License # | 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 3 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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