Provider Demographics
NPI:1609762723
Name:COLE, SHARON VERNELL I
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:VERNELL
Last Name:COLE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19006 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-1816
Mailing Address - Country:US
Mailing Address - Phone:402-750-9664
Mailing Address - Fax:
Practice Address - Street 1:19006 LAKE ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-1816
Practice Address - Country:US
Practice Address - Phone:402-750-9664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion