Provider Demographics
NPI:1609006790
Name:COLE, CHRISTA NICOLE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:NICOLE
Last Name:COLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTA
Other - Middle Name:NICOLE
Other - Last Name:MCPEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:SUITE 255
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-244-2030
Mailing Address - Fax:865-410-7292
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:SUITE 255
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-244-2030
Practice Address - Fax:865-410-7292
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1784DT152W00000X
TNOD0000003088152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist