MEDICARE: MS. LUTONYA IRIS COTTLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		MI

General Provider Information

NPI Number	:	1447103031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LUTONYA IRIS COTTLE

Provider Business Mailing Address
First Line	:	620 GREEN AVE
Second Line	:
City	:	BENTON HARBOR
State	:	MI
Zip	:	49022-3214
Country	:	US
Telephone Number	:	269-313-7718
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 WATER ST
Second Line	:
City	:	BENTON HARBOR
State	:	MI
Zip	:	49022-3451
Country	:	US
Telephone Number	:	269-313-7718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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