Provider Demographics
NPI:1083921282
Name:NOLAN, ALEXIS LEIGH (CNM)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:LEIGH
Last Name:NOLAN
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:121 MEDICAL CENTER DR
Mailing Address - Street 2:STE 2700
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2669
Mailing Address - Country:US
Mailing Address - Phone:207-721-8700
Mailing Address - Fax:207-721-8715
Practice Address - Street 1:121 MEDICAL CENTER DR
Practice Address - Street 2:STE 2700
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2669
Practice Address - Country:US
Practice Address - Phone:207-721-8700
Practice Address - Fax:207-721-8715
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2016-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MECNM132002367A00000X
NM604176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME3351401Medicare PIN