Individual
JANE NOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1219
(704) 304-5765
Mailing address
1738 BARDSTOWN RD, CHARLOTTE, NC 28226-0915
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
50376
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051804
—
NC
05
—
NAN396
—
SC
Enumeration date
06/02/2006
Last updated
09/20/2010
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