Healthcare Provider Details

I. General information

NPI: 1003698408
Provider Name (Legal Business Name): JENNA COTTRELL MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21258 M 68 HWY
ONAWAY MI
49765-9663
US

IV. Provider business mailing address

18811 COUNTY ROAD 451
HILLMAN MI
49746-7978
US

V. Phone/Fax

Practice location:
  • Phone: 989-318-4606
  • Fax:
Mailing address:
  • Phone: 734-756-3851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704349232
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: