Provider Demographics
NPI:1770863185
Name:COLE, ANGELA R (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:COLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 24120
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-2120
Mailing Address - Country:US
Mailing Address - Phone:865-803-4321
Mailing Address - Fax:865-988-5658
Practice Address - Street 1:9711 SHERILL BLVD.
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3330
Practice Address - Country:US
Practice Address - Phone:865-373-5025
Practice Address - Fax:865-373-5011
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN16045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525919Medicaid