Provider Demographics
NPI:1548268253
Name:NOLL, CECELIA L (ARNP-C)
Entity type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:L
Last Name:NOLL
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:MRS
Other - First Name:CECELIA
Other - Middle Name:L
Other - Last Name:SLOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:9 GREENWAY PLZ
Mailing Address - Street 2:SUITE 2950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0905
Mailing Address - Country:US
Mailing Address - Phone:866-607-7334
Mailing Address - Fax:713-358-4801
Practice Address - Street 1:1434 WELLS BRANCH PKWY
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3153
Practice Address - Country:US
Practice Address - Phone:866-607-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L 12063OtherPTAN
KS100341620DMedicaid
TX8L 12064OtherPTAN
TX8L 12064OtherPTAN
KSP00514Medicare UPIN