MEDICARE: LYDIA COLE FNP-C

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	LG-0013245	DE
2	363LF0000X	Family Nurse Practitioner	SP031851	PA
3	163WM0705X	Medical-Surgical Registered Nurse	L1-0050652	DE

General Provider Information

NPI Number	:	1962925628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA COLE FNP-C

Provider Business Mailing Address
First Line	:	1329 N DUPONT ST APT 2
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4076
Country	:	US
Telephone Number	:	302-233-2305
Fax Number	:

Provider Business Practice Location Address
First Line	:	1572 WILMINGTON PIKE STE 1
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-8371
Country	:	US
Telephone Number	:	484-999-3800
Fax Number	:

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

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	02/20/2026

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