Provider Demographics
NPI:1073215075
Name:COLE, SHYENNE TAYLOR
Entity Type:Individual
Prefix:
First Name:SHYENNE
Middle Name:TAYLOR
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 PEARL PENTECOST RD
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-3466
Mailing Address - Country:US
Mailing Address - Phone:828-242-9045
Mailing Address - Fax:
Practice Address - Street 1:378 PEARL PENTECOST RD
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-3466
Practice Address - Country:US
Practice Address - Phone:828-242-9045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach