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General NPI Number Information
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NPI Number | 1427054774
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Entity Type | Individual
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Provider Name | SANDRA J NOLAN APRN
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Gender | Female
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 601 S 169 HWY
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City | SMITHVILLE
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State | MO
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Zip | 64089
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Country | US
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Telephone | 913-684-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 901 E 104TH ST MAILSTOP 400S
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City | KANSAS CITY
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State | MO
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Zip | 64131
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Country | US
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Telephone | 816-502-7117
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Fax | 816-932-9670
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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 | 14-134927-112
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2090009004
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 096307
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License Number State | MO
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