Colleen Mary Nolan, ATC

Individual provider Active NPI Athletic Trainer · Harwich, MA

NPI 1104858802 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104858802
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0752 (MA)
Practice address
4 Derby LN
Harwich, MA 02645-1655
Phone
(508) 737-4054
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0752MAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0752 MA Yes

Addresses

Primary practice location

4 Derby LN
Harwich, MA 02645-1655

Mailing address

4 Derby LN
Harwich, MA 02645-1655
Phone (508) 737-4054

Other providers in Harwich, MA

All providers in Harwich, MA · Athletic Trainer in Massachusetts

Sources for this page

Verify at the official NPI Registry.