Provider Demographics
NPI:1891172763
Name:COLE, DEBRA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2835 HIGHLAND AVE STE C
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-7406
Mailing Address - Country:US
Mailing Address - Phone:619-477-4451
Mailing Address - Fax:619-474-4008
Practice Address - Street 1:2743 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7410
Practice Address - Country:US
Practice Address - Phone:619-474-2284
Practice Address - Fax:619-474-3919
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA393031363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology