Provider Demographics
NPI:1629073275
Name:NOLEN, AGATHA LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:AGATHA
Middle Name:LOUISE
Last Name:NOLEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PINNACLE PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1422
Mailing Address - Country:US
Mailing Address - Phone:615-646-5045
Mailing Address - Fax:
Practice Address - Street 1:304 PINNACLE PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1422
Practice Address - Country:US
Practice Address - Phone:615-400-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-19
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist