Individual
MS. AUDREA NICOLE NOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(206) 769-3441
Mailing address
217 VILLA ALEGRE ST, SANTA FE, NM 87501-1593
(206) 769-3441
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
61367
NM
367500000X
Certified Registered Nurse Anesthetist
302653
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
61367
NM
Other
Enumeration date
08/27/2020
Last updated
11/08/2021
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