Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A5483 | CA |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DOS578 | HI |
NPI | 1194768465 |
---|---|
Provider Name | Sharon L Olson |
First Address | Kamuela, HI 96743-0486 |
Second Address | Sebastopol, CA 95472-4211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 25/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D97601 | (02) | |
HI00496 | NORIDIAN (01) | HI |