Provider Demographics
NPI:1063979458
Name:COLE, AIESHA N (APRN)
Entity type:Individual
Prefix:
First Name:AIESHA
Middle Name:N
Last Name:COLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AIESHA
Other - Middle Name:N
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:234 AMY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40212-2522
Mailing Address - Country:US
Mailing Address - Phone:502-778-0001
Mailing Address - Fax:502-776-1133
Practice Address - Street 1:234 AMY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-2522
Practice Address - Country:US
Practice Address - Phone:502-778-0001
Practice Address - Fax:502-776-1133
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1121062163W00000X
KY57852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1121062OtherKENTUCKY BOARD OF NURSING