Provider Demographics
NPI:1013065275
Name:COLE, JANE M (RN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:COLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64120 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-7749
Mailing Address - Country:US
Mailing Address - Phone:541-820-4671
Mailing Address - Fax:541-820-4671
Practice Address - Street 1:64120 JUNIPER LN
Practice Address - Street 2:
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-7749
Practice Address - Country:US
Practice Address - Phone:541-820-4671
Practice Address - Fax:541-820-4671
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098377Medicaid