Healthcare Provider Details

I. General information

NPI: 1487814794
Provider Name (Legal Business Name): BELINDA HOLLOWAY COLE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42570 S AIRPORT RD
HAMMOND LA
70403-0946
US

IV. Provider business mailing address

PO BOX 20452 YPS CREDENTIALING
COLUMBUS OH
43220-0452
US

V. Phone/Fax

Practice location:
  • Phone: 985-510-6135
  • Fax: 985-510-6202
Mailing address:
  • Phone: 614-442-2406
  • Fax: 614-442-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN084283
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: