Healthcare Provider Details

I. General information

NPI: 1548554470
Provider Name (Legal Business Name): LISA MARIE COTTEN WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 W FRYE RD STE 9
CHANDLER AZ
85224-6277
US

IV. Provider business mailing address

PO BOX 6730
CHANDLER AZ
85246-6730
US

V. Phone/Fax

Practice location:
  • Phone: 480-821-3600
  • Fax: 480-857-2667
Mailing address:
  • Phone: 480-821-3600
  • Fax: 480-821-3610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP4078
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP4078
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: