MEDICARE: MS. CECELIA L NOLL ARNP-C

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	363LF0000X	Family Nurse Practitioner	44759	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8L 12063	OTHER	TX	PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8L 12064	OTHER	TX	PTAN

General Provider Information

NPI Number	:	1548268253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CECELIA L NOLL ARNP-C

Provider Business Mailing Address
First Line	:	9 GREENWAY PLZ
Second Line	:	SUITE 2950
City	:	HOUSTON
State	:	TX
Zip	:	77046-0905
Country	:	US
Telephone Number	:	866-607-7334
Fax Number	:	713-358-4801

Provider Business Practice Location Address
First Line	:	1434 WELLS BRANCH PKWY
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-3153
Country	:	US
Telephone Number	:	866-607-7334
Fax Number	:

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	06/26/2009

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