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NPI Code Detail

MEDICARE: RENA COLE

MEDICARE: RENA 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
1103TC0700XClinical Psychologist0576KS
2103TC0700XClinical Psychologist294KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19460OTHERKSPREFERRED HEALTH SYSTEMS
2389900OTHERKSBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1952353666
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENA COLE
Provider Business Mailing Address
First Line : 635 N MAIN ST
Second Line :
City : WICHITA
State : KS
Zip : 67203-3602
Country : US
Telephone Number : 316-660-7600
Fax Number : 316-383-7925
Provider Business Practice Location Address
First Line : 940 N WACO AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-3947
Country : US
Telephone Number : 316-660-7550
Fax Number : 316-383-8241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/08/2007

Similar Medicare Providers

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Practice Location Address:
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1063463834 — MARIANN FOUNTAIN
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1831140466 — MELISSA GOMEZ-BEYER
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1578515284 — WAYNE J ROTH
Practice Location Address:
940 N WACO AVE
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1285686998 — DAVID J STARK LSCSW
Practice Location Address:
940 N WACO AVE
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67203-3947
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1972556306 — MELISSA A MARTIN
Practice Location Address:
940 N WACO AVE
WICHITA, KS
67203-3947
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Practice Fax: 316-383-8241

Directions to “ RENA COLE ” Practice Location

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