Provider Demographics
NPI:1043496904
Name:COLES, MONICA DIANE (DNP,RN-BC,ACNS-BC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:DIANE
Last Name:COLES
Suffix:
Gender:F
Credentials:DNP,RN-BC,ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4886 HORSEMAN DR NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-5615
Mailing Address - Country:US
Mailing Address - Phone:540-915-4804
Mailing Address - Fax:540-985-5340
Practice Address - Street 1:1906 BELLEVIEW AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1838
Practice Address - Country:US
Practice Address - Phone:540-981-7384
Practice Address - Fax:540-985-5340
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001134039163W00000X
VA0024181805163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse