Provider Demographics
NPI:1376651158
Name:NOLAN, BARBARA EMMA (RD)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:EMMA
Last Name:NOLAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 NORTH RIVER ROAD
Mailing Address - Street 2:DEHART BUILDING, OFFICE 8A
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906
Mailing Address - Country:US
Mailing Address - Phone:765-464-2280
Mailing Address - Fax:765-464-2279
Practice Address - Street 1:3851 N RIVER RD
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE BRA
Practice Address - State:IN
Practice Address - Zip Code:47906-3762
Practice Address - Country:US
Practice Address - Phone:765-464-2280
Practice Address - Fax:765-464-2279
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37000737A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered