Healthcare Provider Details

I. General information

NPI: 1275751828
Provider Name (Legal Business Name): BARBARA H COLE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E PARK AVE SUITE 312
STATE COLLEGE PA
16803-6706
US

IV. Provider business mailing address

1850 E PARK AVE SUITE 312
STATE COLLEGE PA
16803-6706
US

V. Phone/Fax

Practice location:
  • Phone: 814-235-2480
  • Fax: 814-235-2482
Mailing address:
  • Phone: 814-235-2480
  • Fax: 814-235-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP005665B
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: