Individual
MS. MARY ELLEN COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,CRNP
Contact information
Practice address
100 TOWNCENTER BLVD, SUITE 112, TUSCALOOSA, AL 35406-1833
(205) 750-0030
(205) 750-0855
Mailing address
100 TOWNCENTER BLVD, SUITE 112, TUSCALOOSA, AL 35406-1833
(205) 750-0030
(205) 750-0855
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1030536
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051592254
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/12/2006
Last updated
06/18/2010
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