Individual
CONNIE S. COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5900 E 500 N, KENDALLVILLE, IN 46755-9349
(260) 349-8185
Mailing address
5900 E 500 N, KENDALLVILLE, IN 46755-9349
(260) 347-5630
(888) 347-0088
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71003622A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71003622A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201023770
—
IN
01
—
P01055058
RR MEDICARE
—
Enumeration date
05/27/2011
Last updated
05/27/2014
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