Individual
BIANCA NOEL NOLTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(800) 284-8288
Mailing address
48245 MANHATTAN CIR, CANTON, MI 48188-1498
(734) 756-1133
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704318922
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704318922NSA2606R
MI
Other
Enumeration date
10/22/2025
Last updated
03/20/2026
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