Provider Demographics
NPI:1194979351
Name:NOLAN, ANGELA M (RD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:NOLAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 ANDERLEA DR
Mailing Address - Street 2:
Mailing Address - City:ROMANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4856
Mailing Address - Country:US
Mailing Address - Phone:267-760-7778
Mailing Address - Fax:267-760-7778
Practice Address - Street 1:1217 ANDERLEA DR
Practice Address - Street 2:
Practice Address - City:ROMANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-4856
Practice Address - Country:US
Practice Address - Phone:267-760-7778
Practice Address - Fax:267-760-7778
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004001133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered