Provider Demographics
NPI:1467853234
Name:NOLAN, ERICA (LPN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:BLOMBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1186 SW GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1329
Mailing Address - Country:US
Mailing Address - Phone:785-249-7757
Mailing Address - Fax:
Practice Address - Street 1:2200 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66622-0001
Practice Address - Country:US
Practice Address - Phone:785-350-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-45483-052164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS23-45483-052OtherLPN LICENSE NUMBER