Provider Demographics
NPI:1861616070
Name:COLE, GITANA B (APRN)
Entity type:Individual
Prefix:
First Name:GITANA
Middle Name:B
Last Name:COLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:151 N EAGLE CREEK DR
Mailing Address - Street 2:STE 320
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1889
Mailing Address - Country:US
Mailing Address - Phone:859-543-0005
Mailing Address - Fax:859-543-0474
Practice Address - Street 1:151 N EAGLE CREEK DR
Practice Address - Street 2:STE 320
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1889
Practice Address - Country:US
Practice Address - Phone:859-543-0005
Practice Address - Fax:859-543-0474
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3003049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64213978Medicaid
KY64213978Medicaid
KYK042230Medicare PIN
KY0076512Medicare PIN