Provider Demographics
NPI:1750305967
Name:COLE, CATHY JANE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:JANE
Last Name:COLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-4142
Mailing Address - Country:US
Mailing Address - Phone:337-824-1000
Mailing Address - Fax:
Practice Address - Street 1:1907 JOHNSON STREET
Practice Address - Street 2:JENNINGS OUTPATIENT CLINIC
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-9998
Practice Address - Country:US
Practice Address - Phone:337-824-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO3791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily