Healthcare Provider Details

I. General information

NPI: 1043923766
Provider Name (Legal Business Name): ALICIA MICHELE COLE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 PLEASANT HILL RD
DULUTH GA
30096-2321
US

IV. Provider business mailing address

2131 PLEASANT HILL RD STE 124
DULUTH GA
30096-4657
US

V. Phone/Fax

Practice location:
  • Phone: 404-943-9996
  • Fax: 404-943-9975
Mailing address:
  • Phone: 470-289-0924
  • Fax: 770-622-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number905700
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP001793
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: