Provider Demographics
NPI:1124259593
Name:NOLAN, SARAH BETH (LPN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:NOLAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 LANGDON ST
Mailing Address - Street 2:APT 308
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1155
Mailing Address - Country:US
Mailing Address - Phone:815-541-1881
Mailing Address - Fax:
Practice Address - Street 1:626 LANGDON ST
Practice Address - Street 2:APT 308
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-1155
Practice Address - Country:US
Practice Address - Phone:815-541-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043106738164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse