MEDICARE: DANIEL WALTER NOLA ND

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	175F00000X	Naturopath	25-1946	AZ

General Provider Information

NPI Number	:	1437049533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL WALTER NOLA ND

Provider Business Mailing Address
First Line	:	12621 N TATUM BLVD # 2088
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-7710
Country	:	US
Telephone Number	:	480-485-5964
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 W INDIAN SCHOOL RD STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3200
Country	:	US
Telephone Number	:	602-234-1158
Fax Number	:

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

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	12/07/2025

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Directions to “ DANIEL WALTER NOLA ND” Practice Location

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