Provider Demographics
NPI:1851867287
Name:NIELSEN, COLE (PA)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE STE 740
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3926
Mailing Address - Country:US
Mailing Address - Phone:720-386-4508
Mailing Address - Fax:
Practice Address - Street 1:4500 E 9TH AVE STE 740
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3926
Practice Address - Country:US
Practice Address - Phone:720-386-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0005537363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant