Provider Demographics
NPI:1215730262
Name:COLE, TAELOR MARIE
Entity type:Individual
Prefix:
First Name:TAELOR
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68937-0203
Mailing Address - Country:US
Mailing Address - Phone:308-216-1346
Mailing Address - Fax:
Practice Address - Street 1:75203 ROAD 425
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:NE
Practice Address - Zip Code:68937-2808
Practice Address - Country:US
Practice Address - Phone:308-785-2541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion