Provider Demographics
NPI:1104105790
Name:COLE, NANCY A
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 ALBACATE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-3503
Mailing Address - Country:US
Mailing Address - Phone:303-328-7017
Mailing Address - Fax:
Practice Address - Street 1:2831 SAINT ROSE PKWY
Practice Address - Street 2:SUITE 236
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4840
Practice Address - Country:US
Practice Address - Phone:702-589-4865
Practice Address - Fax:702-589-4866
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner