Healthcare Provider Details

I. General information

NPI: 1265874812
Provider Name (Legal Business Name): CHRISTINE LOUISE COLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MEMORIAL BLVD W
HAGERSTOWN MD
21740-6219
US

IV. Provider business mailing address

303 MEMORIAL BLVD W
HAGERSTOWN MD
21740-6219
US

V. Phone/Fax

Practice location:
  • Phone: 301-791-7060
  • Fax: 301-791-8990
Mailing address:
  • Phone: 301-791-7060
  • Fax: 301-791-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR180444
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: