Provider Demographics
NPI:1548803919
Name:NOEL, ANNA KATHRYN (RNC, NNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHRYN
Last Name:NOEL
Suffix:
Gender:F
Credentials:RNC, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 AMANDA BELLE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-9529
Mailing Address - Country:US
Mailing Address - Phone:601-213-6142
Mailing Address - Fax:
Practice Address - Street 1:1407 UNION AVE STE 700
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3641
Practice Address - Country:US
Practice Address - Phone:901-866-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN266912080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine