MEDICARE: DASHARIA MONIQUE NOLAN LPN, AS

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	164W00000X	Licensed Practical Nurse	90268	TN

General Provider Information

NPI Number	:	1457213563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DASHARIA MONIQUE NOLAN LPN, AS

Provider Business Mailing Address
First Line	:	1214 AUSTIN HOMES BLVD UNIT 103
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37915-1345
Country	:	US
Telephone Number	:	865-719-6250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 AUSTIN HOMES BLVD UNIT 103
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37915-1345
Country	:	US
Telephone Number	:	865-719-6250
Fax Number	:

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

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	12/01/2025

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