Provider Demographics
NPI:1710251939
Name:NOLEN, JOAN ELOUISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:ELOUISE
Last Name:NOLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 RUBIO CANYON RD
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1523
Mailing Address - Country:US
Mailing Address - Phone:626-794-9561
Mailing Address - Fax:626-794-9561
Practice Address - Street 1:3211 RUBIO CANYON RD
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-1523
Practice Address - Country:US
Practice Address - Phone:626-794-9561
Practice Address - Fax:626-794-9561
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299677163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse