Individual
CONSTANCE NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
501 S UNION AVE, HAVRE DE GRACE, MD 21078-3409
(410) 843-8800
Mailing address
501 S UNION AVE, HAVRE DE GRACE, MD 21078-3409
(410) 843-8800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R053391
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R053391
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
673000100
—
MD
Enumeration date
12/22/2015
Last updated
05/18/2017
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