Provider Demographics
NPI:1548998511
Name:NOBLE, DORIS JEAN (ALZHEIMER'S CERT)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:JEAN
Last Name:NOBLE
Suffix:
Gender:F
Credentials:ALZHEIMER'S CERT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4645
Mailing Address - Country:US
Mailing Address - Phone:870-713-0633
Mailing Address - Fax:
Practice Address - Street 1:1614 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4645
Practice Address - Country:US
Practice Address - Phone:870-713-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty