Healthcare Provider Details

I. General information

NPI: 1598614372
Provider Name (Legal Business Name): ELLA COLE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE RD STE 502
LEXINGTON KY
40503-1487
US

IV. Provider business mailing address

1720 NICHOLASVILLE RD STE 502
LEXINGTON KY
40503-1487
US

V. Phone/Fax

Practice location:
  • Phone: 850-277-7129
  • Fax: 859-277-9613
Mailing address:
  • Phone: 850-277-7129
  • Fax: 859-277-9613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC026
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: