Provider Demographics
NPI:1033144191
Name:NOLAN, TRAMPAS S (ARNP)
Entity Type:Individual
Prefix:MR
First Name:TRAMPAS
Middle Name:S
Last Name:NOLAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-0518
Mailing Address - Country:US
Mailing Address - Phone:606-545-0400
Mailing Address - Fax:606-545-0433
Practice Address - Street 1:215 TREUHAFT BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7361
Practice Address - Country:US
Practice Address - Phone:606-545-0400
Practice Address - Fax:606-545-0433
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4312P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78012564Medicaid
KYQ21329Medicare UPIN
KY78012564Medicaid