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Individual
SANDRA J NOLAN
Active
Individual
SANDRA J NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-134927-112
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
096307
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2090009004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096307
LICENSE
MO
01
—
0MT0372665
BLUE CROSS-SHIELD OF MONTANA
MT
05
—
424769115
—
MO
Enumeration date
06/22/2005
Last updated
01/16/2019
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