Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 4704244423 | MI |
NPI | 1003299272 |
---|---|
Provider Name | Jessica L Cotton |
First Address | Battle Creek, MI 49015-9345 |
Second Address | Battle Creek, MI 49015-9345 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2015 |
Last Update Date | 21/10/2015 |