Individual
CARISSA COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
301 E SOUTHLINE RD, TUSCOLA, IL 61953-2014
(217) 253-5231
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209019303
IL
363LF0000X
Family Nurse Practitioner
Primary
209019303
IL
Other
Enumeration date
08/22/2019
Last updated
05/01/2025
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