MEDICARE: HAJA Z COLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SH0200X	Home Health Clinical Nurse Specialist	R4636P	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R4636P	OTHER	MD	LICENSE NO.

General Provider Information

NPI Number	:	1366045494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAJA Z COLE

Provider Business Mailing Address
First Line	:	8704 DEVON HILLS DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-7165
Country	:	US
Telephone Number	:	301-974-7868
Fax Number	:

Provider Business Practice Location Address
First Line	:	8704 DEVON HILLS DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-7165
Country	:	US
Telephone Number	:	301-974-7868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2020
Last Update Date	:	11/20/2020

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Directions to “ HAJA Z COLE ” Practice Location

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