Provider Demographics
NPI:1407527419
Name:NOLAN, ZACHARY RYAN (CRNP)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:RYAN
Last Name:NOLAN
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1415 EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3217
Mailing Address - Country:US
Mailing Address - Phone:814-615-2014
Mailing Address - Fax:814-269-1318
Practice Address - Street 1:1415 EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3217
Practice Address - Country:US
Practice Address - Phone:814-615-2014
Practice Address - Fax:814-269-1318
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP024306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily