Individual
JACOB JOHNSTON NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2824 ELKHART RD, GOSHEN, IN 46526-1014
(574) 535-1700
(574) 535-1799
Mailing address
2824 ELKHART RD, GOSHEN, IN 46526-1014
(574) 825-3888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002996A
IN
Other
Enumeration date
11/03/2020
Last updated
04/21/2023
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