Provider Demographics
NPI:1073795688
Name:HENDERSON-COLE, NICOLE M (MSN, APN-BC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:HENDERSON-COLE
Suffix:
Gender:F
Credentials:MSN, APN-BC
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:M
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-BC
Mailing Address - Street 1:765 ROUTE 70 E BLDG A
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2341
Mailing Address - Country:US
Mailing Address - Phone:856-797-4858
Mailing Address - Fax:856-797-4785
Practice Address - Street 1:765 ROUTE 70 E BLDG A
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-797-4858
Practice Address - Fax:856-797-4785
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANPPA043263363LP0808X
NJ26NJ00148100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health