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General NPI Number Information
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NPI Number | 1326345943
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Entity Type | Individual
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Provider Name | MR. STEVEN A NOLAN
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Gender | Male
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 904 W TEMPLE AVE
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City | EFFINGHAM
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State | IL
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Zip | 62401-2178
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Country | US
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Telephone | 217-342-1234
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Fax | 217-342-1230
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Provider Business Mailing Address
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Address Line | PO BOX 372
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City | MATTOON
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State | IL
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Zip | 61938-0372
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2007002239
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.355743
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 20110007025
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209009746
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License Number State | IL
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