Provider Demographics
NPI:1952691768
Name:COLE, ALISHA MARIE (PA)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:560 W MITCHELL ST STE 560
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2279
Mailing Address - Country:US
Mailing Address - Phone:231-487-5400
Mailing Address - Fax:231-487-5301
Practice Address - Street 1:560 W MITCHELL ST STE 560
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2279
Practice Address - Country:US
Practice Address - Phone:231-487-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601006413363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical