Healthcare Provider Details

I. General information

NPI: 1134963127
Provider Name (Legal Business Name): ABRAE JADE COLE LDN, CNS, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 16TH ST
CODY WY
82414-4706
US

IV. Provider business mailing address

1831 16TH ST
CODY WY
82414-4706
US

V. Phone/Fax

Practice location:
  • Phone: 307-250-3383
  • Fax:
Mailing address:
  • Phone: 307-250-3383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU61579899
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberCNS19127
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND14486
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3196281
License Number State
# 6
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberCNS19127
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: