Provider Demographics
NPI:1285676080
Name:COLE, JONATHAN T (APN)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:T
Last Name:COLE
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:
Practice Address - Street 1:222 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1852
Practice Address - Country:US
Practice Address - Phone:629-255-2112
Practice Address - Fax:629-255-4184
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN07322363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1570540OtherFIRST HEALTH/COVENTRY
TN3344354Medicaid
TN1074562OtherUSA MCO
4090066OtherBLUE CROSS OF TN
KY7100072510Medicaid
TNP00158208OtherMEDICARE RR
KY7100072510Medicaid
TNP00158208OtherMEDICARE RR
S46396Medicare UPIN