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NPI Code Detail

MEDICARE: NOLAN BRIAN ANDRE APRN

MEDICARE:   NOLAN BRIAN ANDRE  APRN
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
1363LF0000XFamily Nurse Practitioner1126556TX

General Provider Information

NPI Number : 1588343784
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOLAN BRIAN ANDRE APRN
Provider Business Mailing Address
First Line : 4524 MATTIE ST APT 215
Second Line :
City : AUSTIN
State : TX
Zip : 78723-5561
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 W KOENIG LN UNIT 100
Second Line :
City : AUSTIN
State : TX
Zip : 78751-1273
Country : US
Telephone Number : 833-937-5463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2023
Last Update Date : 07/14/2023

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Directions to “ NOLAN BRIAN ANDRE APRN” Practice Location

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