Provider Demographics
NPI:1811033129
Name:NOLAN, PATRICIA BURNSED (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BURNSED
Last Name:NOLAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:BURNSED
Other - Last Name:NOLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:832 W CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1809
Mailing Address - Country:US
Mailing Address - Phone:407-275-7976
Mailing Address - Fax:
Practice Address - Street 1:832 W CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1809
Practice Address - Country:US
Practice Address - Phone:407-275-7976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN450482363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0346373-00Medicaid
FLY5230YOtherMEDICARE ID DEPART OF HEALTH
FLY5230YOtherMEDICARE ID DEPART OF HEALTH
FLS05642Medicare UPIN