Individual provider Active NPI

Jacqueline G. Nolen, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • San Antonio, TX
National Provider Identifier
1104130475
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
10924-040 Issued in WI
Practice address
7400 Merton Minter Blvd.
San Antonio, TX 78229
Phone
(210) 617-5300
NPI assigned
Jul 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 10924-040 WI Primary

Addresses

Primary practice location

7400 Merton Minter Blvd.
San Antonio, TX 78229

Mailing address

24860 Breeze Oak
San Antonio, TX 78255-2047
Phone (210) 883-1078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
10924-040WIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1104130475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24860 BREEZE OAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782552047",
            "telephone_number": "210-883-1078",
            "fax_number": "210-822-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER BLVD.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-617-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JACQUELINE",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "10924-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.