Healthcare Provider Details

I. General information

NPI: 1932487311
Provider Name (Legal Business Name): LORI ANN KEISER COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CRAIL ST
JENNINGS LA
70546-6010
US

IV. Provider business mailing address

310 CRAIL ST
JENNINGS LA
70546-6010
US

V. Phone/Fax

Practice location:
  • Phone: 386-337-2018
  • Fax:
Mailing address:
  • Phone: 386-337-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberOAT11813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: