Nolan, Thea Marie

Nolan, Thea Marie is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Nolan, Thea Marie can be contacted via phone (508) 334-1000.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 334-1000
Fax: (775) 442-5891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X Massachusetts

Profile Details

NPI number 1417213448
LBN Legal business name Nolan, Thea Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2012
Last updated Jun 7th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417213448 NPPES
Massachusetts MEDICAID 110123013A

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