Provider Demographics
NPI:1275308868
Name:NOLAN, JONI
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:119 JONES ST
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-1312
Mailing Address - Country:US
Mailing Address - Phone:740-245-2456
Mailing Address - Fax:
Practice Address - Street 1:242 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3414
Practice Address - Country:US
Practice Address - Phone:740-703-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.181428.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse