Provider Demographics
NPI:1457326704
Name:KROUT-COLE, LONNA (FNP)
Entity Type:Individual
Prefix:
First Name:LONNA
Middle Name:
Last Name:KROUT-COLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8777
Mailing Address - Fax:757-232-8866
Practice Address - Street 1:7151 RICHMOND RD
Practice Address - Street 2:SUITE 405
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-7234
Practice Address - Country:US
Practice Address - Phone:757-564-3700
Practice Address - Fax:757-564-8515
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001125434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7790368Medicaid
VA500000933Medicare ID - Type Unspecified
VAS56010Medicare UPIN