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NPI Code Detail

MEDICARE: LORI E COLE CRNA

MEDICARE: LORI E COLE CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistC01506AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15Y196OTHERARBCBS
2P00202215OTHERRRMCR/PGBA
3P00202215OTHERRR MCR
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407851439
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI E COLE CRNA
Provider Business Mailing Address
First Line : PO BOX 1272
Second Line :
City : PINE BLUFF
State : AR
Zip : 71613-1272
Country : US
Telephone Number : 870-535-7457
Fax Number : 870-535-2522
Provider Business Practice Location Address
First Line : 1801 W 40TH AVE
Second Line : STE 2B
City : PINE BLUFF
State : AR
Zip : 71603-6957
Country : US
Telephone Number : 870-535-7457
Fax Number : 870-535-2522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 05/27/2022

Similar Medicare Providers

1053316067 — FAWAD H WALAJAHI M.D.
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522
1497750418 — JEFFREY S BRYLES M.D.
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522
1306841358 — JON C VALENTINE CRNA
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522
1356346316 — WALTER P THERIOT CRNA
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522
1174528186 — FERDINAND K SAMUEL M.D.
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522
1023013000 — GARY W MANLY CRNA
Practice Location Address:
1801 W 40TH AVE , STE 2B
PINE BLUFF, AR
71603-6957
Practice Phone: 870-535-7457
Practice Fax: 870-535-2522

Directions to “ LORI E COLE CRNA” Practice Location

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