Healthcare Provider Details

I. General information

NPI: 1487696555
Provider Name (Legal Business Name): MAUREEN LLOYD NOLAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ROBINSON STREET SUITE 100
POTTSTOWN PA
19464-6439
US

IV. Provider business mailing address

460 NORRISTOWN RD SUITE 100
BLUE BELL PA
19922
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-9460
  • Fax: 610-326-2432
Mailing address:
  • Phone: 610-941-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008875
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: