Provider Demographics
NPI:1093266173
Name:THORCHON, NOSLINE
Entity Type:Individual
Prefix:
First Name:NOSLINE
Middle Name:
Last Name:THORCHON
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:PO BOX 5975
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33466-5975
Mailing Address - Country:US
Mailing Address - Phone:561-598-0310
Mailing Address - Fax:
Practice Address - Street 1:244 LAKE ARBOR DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2160
Practice Address - Country:US
Practice Address - Phone:561-598-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker