Provider Demographics
NPI:1922857713
Name:MCNOLAN HEALTHCARE SERVICES
Entity type:Organization
Organization Name:MCNOLAN HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:POKUAA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:646-965-0900
Mailing Address - Street 1:1330 N SEWARDS CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-3955
Mailing Address - Country:US
Mailing Address - Phone:646-965-0900
Mailing Address - Fax:
Practice Address - Street 1:125 S PHILADELPHIA BLVD OFC 12
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-3205
Practice Address - Country:US
Practice Address - Phone:646-965-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care