MEDICARE: OLUREMI COLE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP141012	TX

General Provider Information

NPI Number	:	1598224313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUREMI COLE

Provider Business Mailing Address
First Line	:	1530 E EUCLID AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50313-4726
Country	:	US
Telephone Number	:	515-989-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	6902 S PEEK RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1741
Country	:	US
Telephone Number	:	832-782-3536
Fax Number	:

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

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	04/07/2022

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Directions to “ OLUREMI COLE ” Practice Location

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