Provider Demographics
NPI:1992149694
Name:COLE, JANE LIZABETH (RN, BSN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:LIZABETH
Last Name:COLE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-0699
Mailing Address - Country:US
Mailing Address - Phone:719-539-4510
Mailing Address - Fax:719-539-7197
Practice Address - Street 1:448 E 1ST ST STE 137
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2867
Practice Address - Country:US
Practice Address - Phone:719-539-4510
Practice Address - Fax:719-539-7197
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO198680163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse