Provider Demographics
NPI:1568272250
Name:COLE, STEPHANIE CHARLENE (BS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CHARLENE
Last Name:COLE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 W MCEACHERN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-1256
Mailing Address - Country:US
Mailing Address - Phone:404-630-2693
Mailing Address - Fax:
Practice Address - Street 1:4821 W MCEACHERN WOODS DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-1256
Practice Address - Country:US
Practice Address - Phone:404-630-2693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty