Provider Demographics
NPI:1861223984
Name:OLSEN, JESSICA YOLANDA (CRNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:YOLANDA
Last Name:OLSEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVE STE GR10
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-235-5874
Mailing Address - Fax:
Practice Address - Street 1:4815 LIBERTY AVE STE GR10
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-235-5874
Practice Address - Fax:412-235-5877
Is Sole Proprietor?:No
Enumeration Date:2024-08-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02241055.363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner