Provider Demographics
NPI:1780446559
Name:COLE, COURTNEY (DNP, APRN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:DNP, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17017 FALSTONE MILL CT
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1181
Mailing Address - Country:US
Mailing Address - Phone:314-724-1184
Mailing Address - Fax:
Practice Address - Street 1:17017 FALSTONE MILL CT
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1181
Practice Address - Country:US
Practice Address - Phone:314-724-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104755607363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health