Healthcare Provider Details

I. General information

NPI: 1558872903
Provider Name (Legal Business Name): ALLYSON COLE BAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLYSON M COLE

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 DEPUTY BILL CANTRELL MEMORIAL RD SUITE 300
CUMMING GA
30040
US

IV. Provider business mailing address

4150 DEP BILL CANTRELL MEMORIAL RD STE 300
CUMMING GA
30040-3007
US

V. Phone/Fax

Practice location:
  • Phone: 770-886-8111
  • Fax:
Mailing address:
  • Phone: 770-886-8111
  • Fax: 770-205-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP248352
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: