Provider Demographics
NPI:1972586410
Name:OLMSTEAD, CHERYL-SUE (NP)
Entity type:Individual
Prefix:MS
First Name:CHERYL-SUE
Middle Name:
Last Name:OLMSTEAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0040
Mailing Address - Country:US
Mailing Address - Phone:207-498-2359
Mailing Address - Fax:207-498-3947
Practice Address - Street 1:163 VAN BUREN RD
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-3567
Practice Address - Country:US
Practice Address - Phone:207-498-6921
Practice Address - Fax:207-498-1697
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER029814363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2815210OtherAETNA-HMO
ME040650OtherANTHEM
ME7008224OtherAETNA-NHMO
ME257630099Medicaid
ME2815210OtherAETNA-HMO