Provider Demographics
NPI:1023908613
Name:OLSON, SAMANTHA NIKOLE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:NIKOLE
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BLUEBONNET RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3403
Mailing Address - Country:US
Mailing Address - Phone:267-566-1184
Mailing Address - Fax:
Practice Address - Street 1:17 BLUEBONNET RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-3403
Practice Address - Country:US
Practice Address - Phone:267-566-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program