Provider Demographics
NPI:1265738116
Name:OLSON, NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SW ORALABOR RD
Mailing Address - Street 2:STE D
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7147
Mailing Address - Country:US
Mailing Address - Phone:515-289-1510
Mailing Address - Fax:
Practice Address - Street 1:1510 ORALABOR ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9204
Practice Address - Country:US
Practice Address - Phone:515-289-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor