Provider Demographics
NPI:1396039947
Name:OLSON, CHRISTINE MARIE (ANP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:WALRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3260 PROVIDENCE DRIVE
Mailing Address - Street 2:SUITE 528
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-770-7213
Mailing Address - Fax:907-770-7214
Practice Address - Street 1:3260 PROVIDENCE DRIVE
Practice Address - Street 2:SUITE 528
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-770-7213
Practice Address - Fax:907-770-7214
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1227363L00000X
AKNURU1227363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1573793Medicaid