Provider Demographics
NPI:1427197110
Name:NOLAN, VALERIE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MARLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1356
Mailing Address - Country:US
Mailing Address - Phone:415-381-3508
Mailing Address - Fax:
Practice Address - Street 1:136 N SAN MATEO DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2777
Practice Address - Country:US
Practice Address - Phone:650-558-4396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA365658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA365658OtherREGISTERED NURSE