Provider Demographics
NPI:1841447331
Name:NOLAN, CHRISTINE LYNN (OTR)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN
Last Name:NOLAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27525 ENTERPRISE CIR W
Mailing Address - Street 2:SUITE # 101 C
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4884
Mailing Address - Country:US
Mailing Address - Phone:951-676-7693
Mailing Address - Fax:951-676-7830
Practice Address - Street 1:27525 ENTERPRISE CIR W
Practice Address - Street 2:SUITE # 101 C
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4884
Practice Address - Country:US
Practice Address - Phone:951-676-7693
Practice Address - Fax:951-676-7830
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3984174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist