Provider Demographics
NPI:1083156715
Name:CAROLAN, NORA K
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:K
Last Name:CAROLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BUCKEYE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4101
Mailing Address - Country:US
Mailing Address - Phone:970-581-0128
Mailing Address - Fax:
Practice Address - Street 1:120 BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4101
Practice Address - Country:US
Practice Address - Phone:970-581-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist