Provider Demographics
NPI:1588644181
Name:COLE, JUDITH WOOD (ARNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:WOOD
Last Name:COLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1380
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:NH
Mailing Address - Zip Code:03809-1380
Mailing Address - Country:US
Mailing Address - Phone:603-875-6151
Mailing Address - Fax:603-875-2944
Practice Address - Street 1:ALTON FAMILY MEDICINE
Practice Address - Street 2:82 MAIN STREET
Practice Address - City:ALTON
Practice Address - State:NH
Practice Address - Zip Code:03809
Practice Address - Country:US
Practice Address - Phone:603-875-6151
Practice Address - Fax:603-875-2944
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH018480 23 03363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3083079Medicaid
NH2300461YPNH01OtherANTHEM BLUE CROSS BLUE SH
NHNP1270Medicare ID - Type Unspecified
NH3083079Medicaid