Provider Demographics
NPI:1972334167
Name:COLE, AUDREY SILVERS (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:SILVERS
Last Name:COLE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 HOMEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2950
Mailing Address - Country:US
Mailing Address - Phone:404-545-6364
Mailing Address - Fax:
Practice Address - Street 1:118 HOMEWOOD DR
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2950
Practice Address - Country:US
Practice Address - Phone:404-545-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224364163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant