Provider Demographics
NPI:1891316725
Name:NOLAN, LYNDA (MPH, MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MPH, MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3374
Mailing Address - Country:US
Mailing Address - Phone:908-307-1424
Mailing Address - Fax:
Practice Address - Street 1:24 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3374
Practice Address - Country:US
Practice Address - Phone:908-307-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP002146G363LX0001X
NJ26NN04811600363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology