Doctor Name: | SAMANTHA KATHLEEN COLE |
NPI Number: | 1144651225 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 5006605 |
Business Practice Address: | 1033 Chamberwell Ave Wake Forest, NC - 275877942 |
Business Phone Number: | 9199064284 |
Business Fax Number: | |
Mailing Address: | 1033 Chamberwell Ave, WAKE FOREST |
State: | NC |
Postal Code: | 27587 |
Phone Number: | 9199064284 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2013 |
NPI Last Update Date: | 11/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 5006605 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |