Basic Information
| Provider Information | |||||||||
| NPI: | 1821163890 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOLEN | ||||||||
| FirstName: | ANDREE | ||||||||
| MiddleName: | MARCELLE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PMHNP,MSN, RN, APN-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3005 S LAMAR BLVD # D109-364 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787048864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093566565 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 PROSPECT ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038896147 | ||||||||
| FaxNumber: | 6038831568 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2006 | ||||||||
| LastUpdateDate: | 08/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 461673 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 061541-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.