Provider Demographics
NPI:1831299965
Name:COLE, KRISTEN FREY (RN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:FREY
Last Name:COLE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4523 MALVERN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5643
Mailing Address - Country:US
Mailing Address - Phone:919-450-0710
Mailing Address - Fax:
Practice Address - Street 1:796 DOCTORS CT
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4571
Practice Address - Country:US
Practice Address - Phone:336-598-0002
Practice Address - Fax:336-599-2159
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC005001268363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics