Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 50995 | AZ |
Y | 208600000X | Surgeon | 50995 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 50995 | AZ |
NPI | 1053592139 |
---|---|
Provider Name | Miss Shelley Suzanne Noland |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2007 |
Last Update Date | 02/10/2020 |