Healthcare Provider Details

I. General information

NPI: 1831390962
Provider Name (Legal Business Name): NICOLE MES COTTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR STE 190
STEAMBOAT SPRINGS CO
80487-8853
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 970-875-2619
  • Fax:
Mailing address:
  • Phone: 970-624-4128
  • Fax: 970-490-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD201595
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberDR.0064147
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: