Provider Demographics
NPI:1255033411
Name:COLE, ERIN BLAISE (APRN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:BLAISE
Last Name:COLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5937
Mailing Address - Country:US
Mailing Address - Phone:985-705-7240
Mailing Address - Fax:
Practice Address - Street 1:2331 CAREY ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3627
Practice Address - Country:US
Practice Address - Phone:985-646-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229678363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health