Individual
MS. LAUREEN JUDY NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 POWDERHORN RD, SIMPSONVILLE, SC 29681-3399
(864) 963-3421
Mailing address
20 POWDERHORN RD, SIMPSONVILLE, SC 29681-3399
(864) 963-3421
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD17696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1388N
BCBS OF NC ID#
NC
01
—
2015854
CIGNA ID #
NC
01
—
274073
UNITED BEHAVIORAL HEALTH
NC
05
—
5901246
—
NC
01
—
E0501
MEDCOST ID #
NC
Enumeration date
05/15/2006
Last updated
02/09/2017
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