Provider Demographics
NPI:1558514075
Name:NOLTE, NATHAN MICHAEL (PNP)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:MICHAEL
Last Name:NOLTE
Suffix:
Gender:M
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MEREDITH LN
Mailing Address - Street 2:APT. #111
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4664
Mailing Address - Country:US
Mailing Address - Phone:214-456-0463
Mailing Address - Fax:
Practice Address - Street 1:7211 PRESTON RD STE 1200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024
Practice Address - Country:US
Practice Address - Phone:214-456-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX694177363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics