Provider Demographics
NPI:1215230461
Name:MARIA M COLE FNP-BC PC
Entity Type:Organization
Organization Name:MARIA M COLE FNP-BC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-580-7320
Mailing Address - Street 1:2900 SAN SABA CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-5001
Mailing Address - Country:US
Mailing Address - Phone:432-580-7320
Mailing Address - Fax:432-580-7318
Practice Address - Street 1:5031 WAYLAND DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5534
Practice Address - Country:US
Practice Address - Phone:432-580-7320
Practice Address - Fax:432-580-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1110172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty