Basic Information
| Provider Information | |||||||||
| NPI: | 1629688452 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLE | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | DNP, APRN, AGNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5281 N 99TH AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853052209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235168252 | ||||||||
| FaxNumber: | 6235168253 | ||||||||
| Practice Location | |||||||||
| Address1: | 3811 E BELL RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235168252 | ||||||||
| FaxNumber: | 6235168253 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2020 | ||||||||
| LastUpdateDate: | 10/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 241473 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.