Provider Demographics
NPI:1265543466
Name:OLSON, NANCY Y (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:Y
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1449
Mailing Address - Country:US
Mailing Address - Phone:913-338-3222
Mailing Address - Fax:913-338-3227
Practice Address - Street 1:8401 W 125TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1449
Practice Address - Country:US
Practice Address - Phone:913-338-3222
Practice Address - Fax:913-338-3227
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0422254207K00000X, 2080P0201X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C50756Medicare UPIN