Healthcare Provider Details

I. General information

NPI: 1396344487
Provider Name (Legal Business Name): DANIEL COLE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 N SHIELD ST
KNOX IN
46534-1143
US

IV. Provider business mailing address

16 N SHIELD ST
KNOX IN
46534-1143
US

V. Phone/Fax

Practice location:
  • Phone: 219-363-4659
  • Fax: 219-777-2671
Mailing address:
  • Phone: 219-363-4659
  • Fax: 219-777-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71010468A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: