Provider Demographics
NPI:1710317912
Name:NOLAN, TANYA (CNM)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 RALEY BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8351
Mailing Address - Country:US
Mailing Address - Phone:530-345-4471
Mailing Address - Fax:
Practice Address - Street 1:111 RALEY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8351
Practice Address - Country:US
Practice Address - Phone:530-345-4471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2053176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife