Provider Demographics
NPI:1912965427
Name:NOBLE, NANCY JOAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JOAN
Last Name:NOBLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 OLENTANGY RIVER RD
Mailing Address - Street 2:STE 103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:2030 STRINGTOWN RD
Practice Address - Street 2:WORK REHAB
Practice Address - City:GROUP CITY
Practice Address - State:OH
Practice Address - Zip Code:43123
Practice Address - Country:US
Practice Address - Phone:614-566-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3707103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0871016Medicaid
OHOTH211Medicare UPIN
OH0871016Medicaid