Susan Jane Nolan, PA-C
Physician Assistant, Medical in Port Charlotte, FL. Individual provider (NPI-1).
NPI number1104121243
StatusActive
Last updated in NPPESJun 27, 2024
Details
- NPI
- 1104121243
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Susan Jane Nolan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 21, 2011
- Certification date
- Jun 27, 2024
- Last updated
- Jun 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA9105671 | FL | Yes |
Practice location
22655 Bayshore Rd Ste 110Port Charlotte, FL 33980-2005
Phone 941-235-4900 · Fax 941-235-4901
Mailing address
Po Box 2147Fort Myers, FL 33902-2147
Phone 239-343-6202 · Fax 239-437-8537
Other practice locations
16410 Healthpark Commons Dr
Fort Myers, FL 33908
Fort Myers, FL 33908
Phone 239-343-6202 · Fax 239-437-8537
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