Provider Demographics
NPI:1891009296
Name:COLE, FIONA M (BPHARM)
Entity Type:Individual
Prefix:
First Name:FIONA
Middle Name:M
Last Name:COLE
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 RUNNING DEER DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7173
Mailing Address - Country:US
Mailing Address - Phone:832-361-1491
Mailing Address - Fax:
Practice Address - Street 1:303 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:WV
Practice Address - Zip Code:25570-9605
Practice Address - Country:US
Practice Address - Phone:304-272-6767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25917183500000X
WVRP0007497183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist