Provider Demographics
NPI:1407601537
Name:THROWER, NOLA
Entity type:Individual
Prefix:
First Name:NOLA
Middle Name:
Last Name:THROWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 GRAYSTONE TRCE
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3234
Mailing Address - Country:US
Mailing Address - Phone:757-537-7745
Mailing Address - Fax:
Practice Address - Street 1:128 GRAYSTONE TRCE
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3234
Practice Address - Country:US
Practice Address - Phone:757-537-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA49CERPART40208800000X
VA156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrology