Healthcare Provider Details

I. General information

NPI: 1538220710
Provider Name (Legal Business Name): SHEILA R COLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 N.10TH ST.
ORANGE TX
77630
US

IV. Provider business mailing address

PO BOX 650859 DEPT 710
DALLAS TX
75265-5302
US

V. Phone/Fax

Practice location:
  • Phone: 409-772-2222
  • Fax:
Mailing address:
  • Phone: 409-747-6240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP109224
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP109224
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: