Individual provider Active NPI

Paul Edward Nolan Sr., RN BSN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Largo, MD
National Provider Identifier
1407287311
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
R086541 Issued in MD
Practice address
9475 Lottsford Rd Ste 250
Largo, MD 20774-5346
Phone
(301) 636-6504
Fax
(301) 636-6509
NPI assigned
Dec 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X R086541 MD Primary

Addresses

Primary practice location

9475 Lottsford Rd Ste 250
Largo, MD 20774-5346

Mailing address

9475 Lottsford Rd Ste 250
Largo, MD 20774-5346
Phone (301) 636-6504

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R086541MDMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1407287311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 LOTTSFORD RD STE 250",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745346",
            "telephone_number": "301-636-6504",
            "fax_number": "301-636-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 LOTTSFORD RD STE 250",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745346",
            "telephone_number": "301-636-6504",
            "fax_number": "301-636-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R086541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.