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General NPI Number Information
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NPI Number | 1104210830
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Entity Type | Individual
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Provider Name | AUDRA COLE D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 1200 SE 28TH ST STE 2
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City | BENTONVILLE
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State | AR
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Zip | 72712-4641
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Country | US
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Telephone | 479-271-0005
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Fax | 479-273-1427
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Provider Business Mailing Address
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Address Line | 1200 SE 28TH ST STE 2
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City | BENTONVILLE
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State | AR
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Zip | 72712-4641
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Country | US
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Telephone | 479-271-0005
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Fax | 479-273-1427
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E-12028
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License Number State | AR
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