Provider Demographics
NPI:1750089439
Name:NOLEN INDEPENDENT MANAGEMENT, LLC
Entity type:Organization
Organization Name:NOLEN INDEPENDENT MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:605-431-6480
Mailing Address - Street 1:625 1/2 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2758
Mailing Address - Country:US
Mailing Address - Phone:605-431-6480
Mailing Address - Fax:
Practice Address - Street 1:625 1/2 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2758
Practice Address - Country:US
Practice Address - Phone:605-431-6480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care