Provider Demographics
NPI:1417285636
Name:NOLAN, CARRIE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 MORRILL AVE
Mailing Address - Street 2:UNIT 9
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-3579
Mailing Address - Country:US
Mailing Address - Phone:310-927-0518
Mailing Address - Fax:
Practice Address - Street 1:495 MORRILL AVE
Practice Address - Street 2:UNIT 9
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3579
Practice Address - Country:US
Practice Address - Phone:310-927-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-28
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA636061835P0018X
AZS0176451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist