Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 7944 | CA |
NPI | 1023130622 |
---|---|
Provider Name | Laurel Jean Olslund |
First Address | Oakland, CA 94609-3312 |
Second Address | Berkeley, CA 94705-2067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 05/11/2018 |