Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 003940 | CT |
NPI | 1033363601 |
---|---|
Provider Name | Mrs. Brandi Parker Cotton |
First Address | Pawtucket, RI 02860-5402 |
Second Address | Pawtucket, RI 02860-5402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2008 |
Last Update Date | 10/05/2011 |