Healthcare Provider Details

I. General information

NPI: 1255326005
Provider Name (Legal Business Name): DONNA F NOLAND RNC MSN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 06/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 CENTURY LN
JOHNSON CITY TN
37604-4469
US

IV. Provider business mailing address

365 STOUT DRIVE, BOX 70403
JOHNSON CITY TN
37614-1703
US

V. Phone/Fax

Practice location:
  • Phone: 423-926-2500
  • Fax: 423-926-5999
Mailing address:
  • Phone: 423-439-4515
  • Fax: 423-439-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN000008056
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number8056
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: