Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 0401007602 | VA |
Y | 1223G0001X | General Practice | DN014752 | GA |
Y | 213EG0000X | General Practice | DN014752 | GA |
NPI | 1457493744 |
---|---|
Provider Name | Dr. Nancy Vann Cole |
First Address | Savannah, GA 31404-3917 |
Second Address | Savannah, GA 31404-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 26/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003146412A | (05) | GA |
142948 | ANTHEM HEALTHKEEPERS (01) | VA |
9176779 | (05) | VA |