Provider Demographics
NPI:1548358286
Name:COLE, NANCY SINGLETARY (PAC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:SINGLETARY
Last Name:COLE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:SINGLETARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:4500 W NEWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2245
Mailing Address - Country:US
Mailing Address - Phone:352-336-6000
Mailing Address - Fax:352-332-0799
Practice Address - Street 1:4500 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2245
Practice Address - Country:US
Practice Address - Phone:352-336-6000
Practice Address - Fax:352-336-6063
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104730363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBP885ZMedicare PIN
Q72084Medicare UPIN