Provider Demographics
NPI:1962925628
Name:COLE, LYDIA (FNP-C)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:COLE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 N DUPONT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4076
Mailing Address - Country:US
Mailing Address - Phone:302-233-2305
Mailing Address - Fax:
Practice Address - Street 1:15 W AYLESBURY RD STE 600
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4168
Practice Address - Country:US
Practice Address - Phone:410-575-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031851363LF0000X
DEL1-0050652163WM0705X
MDACOO7372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical