Provider Demographics
NPI:1730938101
Name:COLE, AARON SHAWN (CRNA)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:SHAWN
Last Name:COLE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17902 E 48TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-7408
Mailing Address - Country:US
Mailing Address - Phone:918-740-9220
Mailing Address - Fax:
Practice Address - Street 1:1000 W BOISE CIR
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4900
Practice Address - Country:US
Practice Address - Phone:918-994-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK148713367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered