Provider Demographics
NPI:1790012441
Name:COLE FAMILY PRACTICE
Entity Type:Organization
Organization Name:COLE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:T
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, CNM
Authorized Official - Phone:615-874-3422
Mailing Address - Street 1:226 JACKSON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1425
Mailing Address - Country:US
Mailing Address - Phone:615-874-3422
Mailing Address - Fax:615-874-3465
Practice Address - Street 1:226 JACKSON MEADOWS DR
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1425
Practice Address - Country:US
Practice Address - Phone:615-874-3422
Practice Address - Fax:615-874-3465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14101261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN14101OtherAPN
TN147084OtherRN