Kristin J Olson, CFNP
Individual provider Active NPI Nurse Practitioner · Watertown, MN
NPI 1124002548 · NPPES record last updated Jan 2, 2019
Key facts
- NPI
- 1124002548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 3202 (MN)
- Practice address
- 204 Lewis Ave S
Suite 200
Watertown, MN 55388-4500 - Phone
- (952) 955-1963
- Fax
- (952) 955-1965
- NPI assigned
- Nov 30, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of North Dakota School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeview Clinic, LTD.
Practice addresses (Care Compare)
424 W State Hwy 5
Waconia, MN 55387-1723
Phone (952) 442-4461
Hospital & facility affiliations
- Ridgeview Home Care Services
- Ridgeview Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040309000801 | MN | Practitioner - Nurse Practitioner | 6608764816 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3202 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Clinic, LTD. | Current |
Accepting new patients | |
| Infinite Health Collaborative, PA | Past | Accepting new patients |
Locations
110105 Pioneer Trl W
Chaska, MN 55318
Phone (952) 361-5800
406 Faxon Rd N
Nya, MN 55368
Phone (952) 467-1915
424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461
313 Territorial St E
Watertown, MN 55388
Phone (952) 442-4461
Interoperability endpoints
- kristinolson@tv.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3202 | MN | Yes |
Addresses
Primary practice location
204 Lewis Ave S
Suite 200
Watertown, MN 55388-4500
Mailing address
204 Lewis Ave S
Watertown, MN 55388-4500
Phone (952) 955-1963
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 266948000 | Medicaid | MN |
Other providers in Watertown, MN
- LMN Services
- LMN Services
- Kathleen Mary McCann
- Nicole Marnes Mueller
- Christian Laurits Nielsen
- Ridgeview Clinics
- Rosemary Louise Rosdahl
- Ryan Goetz, P.a.
- Tonya Kay Schrader
- Molli Sherman
All providers in Watertown, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.