Provider Demographics
NPI:1386922086
Name:OLAN, ROBERT KENNETH (RN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:KENNETH
Last Name:OLAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5852 ROBLE LOMA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-2217
Mailing Address - Country:US
Mailing Address - Phone:850-944-4969
Mailing Address - Fax:
Practice Address - Street 1:5852 ROBLE LOMA DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-2217
Practice Address - Country:US
Practice Address - Phone:850-944-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2966322163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care