Provider Demographics
NPI:1891958765
Name:COLE, ROSA MARIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:MARIA
Last Name:COLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CENTER ST
Mailing Address - Street 2:P.O. BOX 137
Mailing Address - City:CALEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:43314-9493
Mailing Address - Country:US
Mailing Address - Phone:740-244-6567
Mailing Address - Fax:
Practice Address - Street 1:115 CENTER ST
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:OH
Practice Address - Zip Code:43314-9493
Practice Address - Country:US
Practice Address - Phone:740-244-6567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 119382 MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse