Provider Demographics
NPI:1437459633
Name:COLE, JENNETTE A (APRN, CFNP, MSN, RNC)
Entity Type:Individual
Prefix:MRS
First Name:JENNETTE
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:APRN, CFNP, MSN, RNC
Other - Prefix:
Other - First Name:JENNETTE
Other - Middle Name:A
Other - Last Name:CLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5001 BRIGHTON HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-0823
Mailing Address - Country:US
Mailing Address - Phone:505-301-3316
Mailing Address - Fax:
Practice Address - Street 1:10511 GOLF COURSE RD NW
Practice Address - Street 2:SUITE 103
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5916
Practice Address - Country:US
Practice Address - Phone:505-232-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily