Provider Demographics
NPI:1578758256
Name:COLE, JANIS KAY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:KAY
Last Name:COLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:402-354-4230
Mailing Address - Fax:402-354-6171
Practice Address - Street 1:515 N 162ND AVE
Practice Address - Street 2:SUITE # 301
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2539
Practice Address - Country:US
Practice Address - Phone:402-354-7320
Practice Address - Fax:402-354-7325
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47037660425Medicaid
IA1578758256Medicaid
IA1578758256OtherMEDICAID
NE42068035512Medicaid
NE42068035512Medicaid
NE098444002Medicare PIN