Provider Demographics
NPI:1902303266
Name:COLE, CINDY SUE (LVN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:SUE
Last Name:COLE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BOWDOIN ST # 4
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:TX
Mailing Address - Zip Code:75773-1207
Mailing Address - Country:US
Mailing Address - Phone:903-638-1711
Mailing Address - Fax:
Practice Address - Street 1:107 BOWDOIN ST # 4
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-1207
Practice Address - Country:US
Practice Address - Phone:903-638-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX145527164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse