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MICHAEL JOHN NOONAN PA-C

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1598090888

Individual Registrant:
 MICHAEL JOHN NOONAN PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
95-A W. 1ST AVE. RIO GRANDE MEDICAL CENTER MONTE VISTA, CO 81144 US
Tel: 719-852-2512  Fax: --

Contact information for business:
223 STALLO ST  MONTE VISTA, CO 81144-1645 US
Tel: 719-850-0613  Fax: --

Registration Information:
NPI: 1598090888
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
COPAL-2886

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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