Provider Demographics
NPI:1144652975
Name:OLSEN, JOSEPHINE KIMBERLY (DO)
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:KIMBERLY
Last Name:OLSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1251 RUDDER LN
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9104
Mailing Address - Country:US
Mailing Address - Phone:206-660-5094
Mailing Address - Fax:
Practice Address - Street 1:1251 RUDDER LN
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9104
Practice Address - Country:US
Practice Address - Phone:206-660-5094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine