Provider Demographics
NPI:1184369985
Name:COLE, ATIRA TIVONIA
Entity type:Individual
Prefix:MS
First Name:ATIRA
Middle Name:TIVONIA
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 1:3214 HARRISON ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-1826
Mailing Address - Country:US
Mailing Address - Phone:816-398-0661
Mailing Address - Fax:
Practice Address - Street 1:4232 TROOST AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-1240
Practice Address - Country:US
Practice Address - Phone:816-541-3718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker