Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 3263 | IA |
NPI | 1013983881 |
---|---|
Provider Name | Kaaren R Olesen |
First Address | Urbandale, IA 50322-3736 |
Second Address | Urbandale, IA 50322-3736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 12/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0262949 | (05) | IA |
49932 | WELLMARK BCBS (01) | IA |
H73933 | (02) | IA |