Healthcare Provider Details

I. General information

NPI: 1215763743
Provider Name (Legal Business Name): EMILY ANN NOLAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 PRINCETON STREET #203
NORTH CHELMSFORD MA
01863
US

IV. Provider business mailing address

505 PLANTATION STREET APT# 509
WORCESTER MA
01605
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-6579
  • Fax:
Mailing address:
  • Phone: 612-391-5326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN2371027
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: