Provider Demographics
NPI:1568681971
Name:OLSON, LYNN MARIE (MSN, CNM, WHNP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:MSN, CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 LAKE LINDERO DR
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1907
Mailing Address - Country:US
Mailing Address - Phone:818-597-9142
Mailing Address - Fax:805-987-9197
Practice Address - Street 1:3901 LAS POSAS RD STE 207
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1506
Practice Address - Country:US
Practice Address - Phone:805-987-6807
Practice Address - Fax:805-987-9197
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1759176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife