Provider Demographics
NPI:1699805788
Name:COLE, MEAGAN
Entity type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:
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 1:12702 DESPLAINES DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7828
Mailing Address - Country:US
Mailing Address - Phone:317-414-1022
Mailing Address - Fax:317-770-4134
Practice Address - Street 1:12702 DESPLAINES DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7828
Practice Address - Country:US
Practice Address - Phone:317-414-1022
Practice Address - Fax:317-770-4134
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist