Active NPI
Kevan Joyce Olson, NP PSYCHIATRIC
- Psychiatric/Mental Health Nurse Practitioner
- Medford, OR
National Provider Identifier
1164538096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 096006565N6
- Practice address
- 255 W Stewart Ave Ste 101
Medford, OR 97501-3600 - Phone
- (541) 772-5992
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 096006565N6 | OR | Primary |
Addresses
Primary practice location
255 W Stewart Ave Ste 101
Medford, OR 97501-3600
Mailing address
PO Box 93
Butte Falls, OR 97522
Phone (541) 488-7341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096006565N6 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1164538096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 93",
"city": "BUTTE FALLS",
"state": "OR",
"postal_code": "97522",
"telephone_number": "541-488-7341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W STEWART AVE STE 101",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975013600",
"telephone_number": "541-772-5992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "KEVAN",
"middle_name": "JOYCE",
"name_prefix": "Mrs.",
"credential": "NP PSYCHIATRIC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "096006565N6",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.