Provider Demographics
NPI:1245695295
Name:OLSEN, JOANNE (RN)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:OLSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:TRUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1554
Mailing Address - Country:US
Mailing Address - Phone:402-917-3411
Mailing Address - Fax:
Practice Address - Street 1:611 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1554
Practice Address - Country:US
Practice Address - Phone:402-917-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117360163W00000X
IAG169181363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse