MEDICARE: JANA LYNNE COLE RN

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	163W00000X	Registered Nurse	RN60453384	WA

General Provider Information

NPI Number	:	1700608346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA LYNNE COLE RN

Provider Business Mailing Address
First Line	:	2220 33RD CT
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-8937
Country	:	US
Telephone Number	:	360-610-1439
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 33RD CT
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-8937
Country	:	US
Telephone Number	:	360-610-1439
Fax Number	:

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

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	10/25/2024

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