Provider Demographics
NPI:1184247454
Name:COLE, RACHEL COLLEEN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:COLLEEN
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1047
Mailing Address - Country:US
Mailing Address - Phone:724-678-1991
Mailing Address - Fax:
Practice Address - Street 1:105 BRAUNLICH DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3348
Practice Address - Country:US
Practice Address - Phone:412-369-7720
Practice Address - Fax:412-369-7751
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022004363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics