Mark Alan Olsen

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704159962 Issued in MI

Practice address

677 E Main St
Centreville, MI 49032-8524

Phone

(269) 467-1000

NPI assigned

Jul 30, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1154930618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328524",
            "telephone_number": "269-467-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704159962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Centreville",
            "affiliation": "N",
            "endpointDescription": "CMH&SAS",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "677 E Main St",
            "city": "Centreville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490328524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Niblock, LLBSW
• Madisyn June Skyler Nielsen
• Elizabeth Ann O'Dell, LMSW
• Alexis Obermesik
• Jeanine Diane Ohlin
• Lindsey Otis
• Linda Sue Overholt, MA LLP LPC
• Abigail Lynn Parshall, LLBSW
• Julie Parsons, LPN
• Kimberly Peet, LMSW

• Registered Nurse in Centreville, MI
• Providers in Centreville, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.