Provider Demographics
NPI:1912464892
Name:NOLL, JANIE KAY (APRN)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:KAY
Last Name:NOLL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANIE
Other - Middle Name:KAY
Other - Last Name:VINEYARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11407 W BELLA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-7414
Mailing Address - Country:US
Mailing Address - Phone:316-737-4815
Mailing Address - Fax:
Practice Address - Street 1:550 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4976
Practice Address - Country:US
Practice Address - Phone:316-962-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78615-051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily