Provider Demographics
NPI:1649879818
Name:COLE, DANA LEE (MMS, PA)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LEE
Last Name:COLE
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Gender:F
Credentials:MMS, PA
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Mailing Address - Street 1:6574 E BRAINERD RD APT 412
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3704
Mailing Address - Country:US
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Practice Address - Street 1:250 PARKBROOKE PL STE 300
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6401
Practice Address - Country:US
Practice Address - Phone:770-870-1780
Practice Address - Fax:770-928-2601
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2024-05-09
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty