MEDICARE: ISABELLA GRACE NOLLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		OK

General Provider Information

NPI Number	:	1285566729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABELLA GRACE NOLLEY

Provider Business Mailing Address
First Line	:	9810 E 42ND ST STE 232
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3653
Country	:	US
Telephone Number	:	918-899-2817
Fax Number	:

Provider Business Practice Location Address
First Line	:	9810 E 42ND ST STE 232
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3653
Country	:	US
Telephone Number	:	918-316-0746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ ISABELLA GRACE NOLLEY ” Practice Location

Language	Start Address	Practice Location

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