Provider Demographics
NPI:1316779358
Name:OLSEN, JENNIFER (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 S ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:WEST GLOVER
Mailing Address - State:VT
Mailing Address - Zip Code:05875-9546
Mailing Address - Country:US
Mailing Address - Phone:617-763-3448
Mailing Address - Fax:
Practice Address - Street 1:1375 S ALBANY RD
Practice Address - Street 2:
Practice Address - City:WEST GLOVER
Practice Address - State:VT
Practice Address - Zip Code:05875-9546
Practice Address - Country:US
Practice Address - Phone:617-763-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0137301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine