Active NPI
Mildred Ethlyn Noble, LPN
- Licensed Practical Nurse
- Fort Rucker, AL
National Provider Identifier
1730350646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 2-058451
- Practice address
- Building 301, Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362 - Phone
- (334) 255-7894
- Fax
- (334) 255-7368
- NPI assigned
- Mar 19, 2008
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2-058451 | AL | Primary |
Addresses
Primary practice location
Building 301, Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362
Mailing address
Building 301, Andrews Avenue
Lyster Army Health Clinic
Fort Rucker, AL 36362
Phone (334) 255-7894
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2-058451 | AL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1730350646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BUILDING 301, ANDREWS AVENUE",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7894",
"fax_number": "334-255-7368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING 301, ANDREWS AVENUE",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7894",
"fax_number": "334-255-7368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOBLE",
"first_name": "MILDRED",
"middle_name": "ETHLYN",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AL",
"license": "2-058451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.