Individual
MRS. THEA SHANI COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308
(404) 686-2773
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-2773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN639160
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN194355
GA
Other
Enumeration date
03/16/2015
Last updated
05/22/2019
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