MEDICARE: DR. AGATHA LOUISE NOLEN PH.D.

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	183500000X	Pharmacist	12851	TN

General Provider Information

NPI Number	:	1629073275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AGATHA LOUISE NOLEN PH.D.

Provider Business Mailing Address
First Line	:	304 PINNACLE PL
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-1422
Country	:	US
Telephone Number	:	615-646-5045
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 PINNACLE PL
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-1422
Country	:	US
Telephone Number	:	615-400-0611
Fax Number	:

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

Provider Enumeration Date	:	06/19/2005
Last Update Date	:	04/27/2022

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