Individual
JUSTIN L COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1203 JEFFERSON ST, LAUREL, MS 39440-4354
(601) 649-2863
(601) 649-9479
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4560
(601) 200-4580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R885111
MS
363LG0600X
Gerontology Nurse Practitioner
Primary
885111
MS
Other
Enumeration date
01/21/2015
Last updated
09/25/2025
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