Provider Demographics
NPI:1952953374
Name:NOLAND, ANNAH E (RN, CDE)
Entity Type:Individual
Prefix:
First Name:ANNAH
Middle Name:E
Last Name:NOLAND
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:MISS
Other - First Name:ANNAH
Other - Middle Name:ELIZABETH
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 23189
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96921-3189
Mailing Address - Country:US
Mailing Address - Phone:671-480-5449
Mailing Address - Fax:
Practice Address - Street 1:851 GOV CARLOS G CAMACHO RD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3153
Practice Address - Country:US
Practice Address - Phone:671-647-8262
Practice Address - Fax:671-648-9400
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GURE2299163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator