Provider Demographics
NPI:1316562820
Name:TEJAN-COLE, AMINATA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:AMINATA
Middle Name:
Last Name:TEJAN-COLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22202 ESTATE HILL DR APT 7205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3526
Mailing Address - Country:US
Mailing Address - Phone:301-377-1069
Mailing Address - Fax:
Practice Address - Street 1:22202 ESTATE HILL DR APT 7205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3526
Practice Address - Country:US
Practice Address - Phone:301-377-1069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP44015164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse