Active NPI
Roseanne E Nolan, PAC
- Physician Assistant
- Eynon, PA
National Provider Identifier
1114064235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA052188
- Practice address
- 681 Scranton Carbondale Hwy
Eynon, PA 18403 - Phone
- (570) 876-5900
- Fax
- (570) 876-5300
- NPI assigned
- Jan 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA052188 | PA | Primary |
Addresses
Primary practice location
681 Scranton Carbondale Hwy
Eynon, PA 18403
Mailing address
760 Main St
Apt B
Simpson, PA 18407
Phone (570) 876-5900
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114064235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 MAIN ST",
"address_2": "APT B",
"city": "SIMPSON",
"state": "PA",
"postal_code": "18407",
"telephone_number": "570-876-5900",
"fax_number": "570-876-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "681 SCRANTON CARBONDALE HWY",
"city": "EYNON",
"state": "PA",
"postal_code": "18403",
"telephone_number": "570-876-5900",
"fax_number": "570-876-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "ROSEANNE",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA052188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eynon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.