MEDICARE: JUDITH WOOD COLE ARNP

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
1	363LF0000X	Family Nurse Practitioner	018480 23 03	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2300461YPNH01	OTHER	NH	ANTHEM BLUE CROSS BLUE SH

General Provider Information

NPI Number	:	1588644181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH WOOD COLE ARNP

Provider Business Mailing Address
First Line	:	P.O. BOX 1380
Second Line	:
City	:	ALTON
State	:	NH
Zip	:	03809-1380
Country	:	US
Telephone Number	:	603-875-6151
Fax Number	:	603-875-2944

Provider Business Practice Location Address
First Line	:	ALTON FAMILY MEDICINE
Second Line	:	82 MAIN STREET
City	:	ALTON
State	:	NH
Zip	:	03809
Country	:	US
Telephone Number	:	603-875-6151
Fax Number	:	603-875-2944

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	09/19/2014

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