Healthcare Provider Details

I. General information

NPI: 1649202953
Provider Name (Legal Business Name): PAULA A COLE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 JV MANGUBAT DR SUITE B
WAYNESBORO TN
38485-2440
US

IV. Provider business mailing address

854 W JAMES CAMPBELL BLVD SUITE 303
COLUMBIA TN
38401-4659
US

V. Phone/Fax

Practice location:
  • Phone: 931-722-9999
  • Fax: 931-722-2049
Mailing address:
  • Phone: 931-722-9999
  • Fax: 931-722-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0000006016
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: