Provider Demographics
NPI:1427056944
Name:OLSON, ERNESTINE LEE (APRN-BC)
Entity type:Individual
Prefix:MS
First Name:ERNESTINE
Middle Name:LEE
Last Name:OLSON
Suffix:
Gender:F
Credentials:APRN-BC
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Mailing Address - Street 1:PO BOX 2309
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-2309
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:1710 S BROADWAY ST
Practice Address - Street 2:SUITE A
Practice Address - City:MARLOW
Practice Address - State:OK
Practice Address - Zip Code:73055-8692
Practice Address - Country:US
Practice Address - Phone:580-658-9100
Practice Address - Fax:580-658-9104
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2016-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK95837363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner