Provider Demographics
NPI:1609032622
Name:COLE, ROXANNE MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 LEMURIA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-6230
Mailing Address - Country:US
Mailing Address - Phone:541-461-6845
Mailing Address - Fax:
Practice Address - Street 1:2003 LEMURIA ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-6230
Practice Address - Country:US
Practice Address - Phone:541-461-6845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR090006222RN163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics