Provider Demographics
NPI:1942009204
Name:NOLL, ELLEN L (MSN, ED, RN)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:L
Last Name:NOLL
Suffix:
Gender:F
Credentials:MSN, ED, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6940
Mailing Address - Country:US
Mailing Address - Phone:219-464-9621
Mailing Address - Fax:
Practice Address - Street 1:2801 EVANS AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6940
Practice Address - Country:US
Practice Address - Phone:219-464-9621
Practice Address - Fax:219-464-9635
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28166176A163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development