Provider Demographics
NPI:1386319002
Name:OLSON, ABBY RENEE (CPNP-PC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:RENEE
Last Name:OLSON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:MN
Mailing Address - Zip Code:55328-9244
Mailing Address - Country:US
Mailing Address - Phone:218-849-4192
Mailing Address - Fax:
Practice Address - Street 1:ABBY OLSON
Practice Address - Street 2:720 NORTHWOOD DR.
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328
Practice Address - Country:US
Practice Address - Phone:218-849-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2252296163WP0200X
MN8931363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics