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MICHAEL JOHN NOONAN PA-C
Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1598090888
Individual Registrant: MICHAEL JOHN NOONAN PA-C
Gender: M
Not Sole Proprietor
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: --
Tel: 719-852-2512 Fax: --
Contact information for business:
223 STALLO ST MONTE VISTA, CO 81144-1645 US
Tel: 719-850-0613 Fax: --
Tel: 719-850-0613 Fax: --
Registration Information:
NPI: 1598090888
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical | CO | PAL-2886 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
