Individual
MRS. MICHELLE DENISE COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
KCSA
Contact information
Practice address
3240 MOUNT MORIAH AVE, OWENSBORO, KY 42303-7805
(270) 686-6168
(270) 686-6140
Mailing address
3240 MOUNT MORIAH AVE, OWENSBORO, KY 42303-7805
(270) 686-6168
(270) 686-6140
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
29422
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64294226
—
KY
Enumeration date
05/02/2008
Last updated
05/02/2008
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