Individual
JAYNE COLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8127 MERRILLVILLE RD, MERRILLVILLE, IN 46410-6158
(219) 769-4855
(219) 757-5629
Mailing address
342 E 109TH AVE, CROWN POINT, IN 46307-8693
(219) 769-4855
(219) 757-5629
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000602A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200327220
—
IN
Enumeration date
04/05/2006
Last updated
09/25/2017
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