Provider Demographics
NPI:1437423720
Name:NOLEN, SUSAN L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:NOLEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 20TH ST
Mailing Address - Street 2:BUILDING #1
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5449
Mailing Address - Country:US
Mailing Address - Phone:334-745-5756
Mailing Address - Fax:334-749-2102
Practice Address - Street 1:121 N 20TH ST
Practice Address - Street 2:BUILDING #1
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5449
Practice Address - Country:US
Practice Address - Phone:334-745-5756
Practice Address - Fax:334-749-2102
Is Sole Proprietor?:No
Enumeration Date:2012-03-04
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist