Provider Demographics
NPI:1174041396
Name:NOONAN, ELENA NOEMI (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:NOEMI
Last Name:NOONAN
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360541
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6541
Mailing Address - Country:US
Mailing Address - Phone:972-525-9900
Mailing Address - Fax:469-333-7988
Practice Address - Street 1:4324 GOLDEN TRIANGLE BLVD # 110
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6314
Practice Address - Country:US
Practice Address - Phone:972-525-9900
Practice Address - Fax:469-333-7988
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR185050363A00000X
TXPA14380363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant