Healthcare Provider Details

I. General information

NPI: 1083829675
Provider Name (Legal Business Name): SHARON ANN COLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 WILDER ST SUITE 5
LOWELL MA
01854-3097
US

IV. Provider business mailing address

596 WHEELER RD
DRACUT MA
01826-4238
US

V. Phone/Fax

Practice location:
  • Phone: 978-934-4991
  • Fax: 978-934-3080
Mailing address:
  • Phone: 978-957-0565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number173295
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: