Provider Demographics
NPI:1649202953
Name:COLE, PAULA A (APN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 W JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4659
Mailing Address - Country:US
Mailing Address - Phone:931-722-9999
Mailing Address - Fax:931-722-2049
Practice Address - Street 1:101 JV MANGUBAT DR
Practice Address - Street 2:SUITE B
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2440
Practice Address - Country:US
Practice Address - Phone:931-722-9999
Practice Address - Fax:931-722-2049
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006016363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3929337Medicaid
TN4091449OtherBCBS OF TN
TN3710089Medicaid
TN3929337Medicaid
TN4091449OtherBCBS OF TN
3929337Medicare ID - Type UnspecifiedMEDICARE NUMBER