Provider Demographics
NPI:1295114692
Name:NOLEN, SALLIE MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:SALLIE
Middle Name:MICHELLE
Last Name:NOLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3113 ROSS ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79103-2700
Mailing Address - Country:US
Mailing Address - Phone:806-374-7341
Mailing Address - Fax:806-322-2485
Practice Address - Street 1:2601 DIMMITT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1833
Practice Address - Country:US
Practice Address - Phone:806-293-8561
Practice Address - Fax:806-322-2485
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily