Provider Demographics
NPI:1396042453
Name:NOON ENTERPRIZES INC
Entity Type:Organization
Organization Name:NOON ENTERPRIZES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:NOON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:404-226-9498
Mailing Address - Street 1:755 WILKINS RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-1839
Mailing Address - Country:US
Mailing Address - Phone:404-226-9498
Mailing Address - Fax:
Practice Address - Street 1:755 WILKINS RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-1839
Practice Address - Country:US
Practice Address - Phone:404-226-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2242363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty