Healthcare Provider Details

I. General information

NPI: 1417158411
Provider Name (Legal Business Name): PAMELA COLE NJAI NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KERR DRUG 200 HIGHWAY 70 EAST
HILLSBOROUGH NC
27278
US

IV. Provider business mailing address

13301 QUARTERHORSE RUN
ROUGEMONT NC
27572-9355
US

V. Phone/Fax

Practice location:
  • Phone: 919-732-7263
  • Fax:
Mailing address:
  • Phone: 919-477-4047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberFL1106244
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: