Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3011858 | KY |
NPI | 1013421981 |
---|---|
Provider Name | William Spencer Cole |
First Address | Glasgow, KY 42141-3454 |
Second Address | Columbia, KY 42728-1123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 29/11/2017 |