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General NPI Number Information
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NPI Number | 1912211145
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Entity Type | Individual
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Provider Name | SHELLY LYNN COLE CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1215 LEE ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22908-3800
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Country | US
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Telephone | 434-244-2283
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 714960
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City | COLUMBUS
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State | OH
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Zip | 43271-4960
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Country | US
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Telephone | 800-800-1617
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Fax | 866-759-5426
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0224173662
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 56255
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License Number State | WV
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