MEDICARE: CARLY JO NOLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	0110-004998	VA

General Provider Information

NPI Number	:	1740663939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY JO NOLA

Provider Business Mailing Address
First Line	:	11350 MCCORMICK ROAD
Second Line	:	EXECUTIVE PLAZA 1, SUITE 501
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031
Country	:	US
Telephone Number	:	410-329-1071
Fax Number	:	410-329-1054

Provider Business Practice Location Address
First Line	:	1420 SPRING HILL RD STE 210
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3006
Country	:	US
Telephone Number	:	703-738-4342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2015
Last Update Date	:	11/06/2018

Similar Medicare Providers

1174502132 — DR. APPAJI GONDI M.D.
Practice Location Address:

1420 SPRING HILL RD , STE 350
MC LEAN, VA
22102-3006

Practice Phone: 703-790-9722
Practice Fax: 703-893-8666

1679541122 — DR. DANIEL R KENDALL DO
Practice Location Address:

1420 SPRING HILL RD STE 210
MC LEAN, VA
22102-3006

Practice Phone: 703-738-4342
Practice Fax:

1639442577 — PHYSICAL MEDICINE ASSOCIATES LTD
Practice Location Address:

1420 SPRING HILL RD STE 210
MC LEAN, VA
22102-3006

Practice Phone: 703-738-4342
Practice Fax: 703-442-4081

1437810074 — CHRISTINA VICTOR
Practice Location Address:

1420 SPRING HILL RD
MC LEAN, VA
22102-3006

Practice Phone: 571-765-1730
Practice Fax:

1700802097 — YUILL BLACK MD AND MICHAEL R KLETZ MD PC
Practice Location Address:

1420 SPRING HILL RD , SUITE 350
MCLEAN, VA
22102-3006

Practice Phone: 703-790-9722
Practice Fax: 703-893-8666

1972521623 — DR. MICHAEL R KLETZ M.D.
Practice Location Address:

1420 SPRING HILL RD , SUITE 350
MCLEAN, VA
22102-3006

Practice Phone: 703-790-9722
Practice Fax:

Directions to “ CARLY JO NOLA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.