Provider Demographics
NPI:1699235929
Name:COLE, EMMLEY L (FNP-BC, APRN)
Entity type:Individual
Prefix:MRS
First Name:EMMLEY
Middle Name:L
Last Name:COLE
Suffix:
Gender:F
Credentials:FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 GILMORE RD
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-6550
Mailing Address - Country:US
Mailing Address - Phone:423-277-0032
Mailing Address - Fax:
Practice Address - Street 1:277 E W BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:TN
Practice Address - Zip Code:37760
Practice Address - Country:US
Practice Address - Phone:865-262-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily