Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 604 | NM |
NPI | 1083921282 |
---|---|
Provider Name | Ms. Alexis Leigh Nolan |
First Address | Brunswick, ME 04011-2669 |
Second Address | Brunswick, ME 04011-2669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2010 |
Last Update Date | 11/02/2016 |