Active NPI
Maryann Olsen, L.P.N.
- Case Manager/Care Coordinator
- Ketchikan, AK
National Provider Identifier
1841409208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 5599
- Practice address
- 4604 North Tongass
Ketchikan, AK 99901 - Phone
- (907) 225-2001
- Fax
- (907) 225-2002
- NPI assigned
- May 22, 2007
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 5599 | AK | Primary |
Addresses
Primary practice location
4604 North Tongass
Ketchikan, AK 99901
Mailing address
4604 North Tongass
P.O.Box 9476
Ketchikan, AK 99901
Phone (907) 225-2001
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5599 | AK | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841409208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4604 NORTH TONGASS",
"address_2": "P.O.BOX 9476",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "99901",
"telephone_number": "907-225-2001",
"fax_number": "907-225-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4604 NORTH TONGASS",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "99901",
"telephone_number": "907-225-2001",
"fax_number": "907-225-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "MARYANN",
"name_prefix": "Mrs.",
"credential": "L.P.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "AK",
"license": "5599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.