Provider Demographics
NPI:1306823372
Name:COLE, SHIRLEY D (CNM)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:D
Last Name:COLE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 N. LAKE CT.
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:419-425-1510
Mailing Address - Fax:419-425-1736
Practice Address - Street 1:1641 N. LAKE CT.
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-425-1510
Practice Address - Fax:419-425-1736
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM02963176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2067310Medicaid
OHAL9232432Medicare ID - Type Unspecified