Doctor Name: | CONSTANCE NOLL |
NPI Number: | 1013372705 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R053391 |
Business Practice Address: | 501 S Union Ave Havre De Grace, MD - 210783409 |
Business Phone Number: | 4108438800 |
Business Fax Number: | |
Mailing Address: | 501 S Union Ave, HAVRE DE GRACE |
State: | MD |
Postal Code: | 210783409 |
Phone Number: | 4108438800 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2015 |
NPI Last Update Date: | 12/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | R053391 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |