Provider Demographics
NPI:1760785075
Name:COLE, MARIA M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:M
Last Name:COLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2900 SAN SABA CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-5001
Mailing Address - Country:US
Mailing Address - Phone:432-580-7320
Mailing Address - Fax:432-580-7318
Practice Address - Street 1:5031 WAYLAND DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5534
Practice Address - Country:US
Practice Address - Phone:432-580-7320
Practice Address - Fax:432-580-7318
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1110172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285819301Medicaid
TX285819301Medicaid