| Doctor Name: | MS. AUDRA A NOONAN |
| NPI Number: | 1083085575 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN CNP |
| License Number: | APRN00762 |
| Business Practice Address: | 30 Baltimore St Millis, MA - 020541702 |
| Business Phone Number: | 4013165306 |
| Business Fax Number: | |
| Mailing Address: | 30 Baltimore St, MILLIS |
| State: | MA |
| Postal Code: | 020541702 |
| Phone Number: | 4013165306 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2015 |
| NPI Last Update Date: | 10/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | APRN00762 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |