Healthcare Provider Details

I. General information

NPI: 1881404986
Provider Name (Legal Business Name): SHAYNA NICOLE MORTON COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7223 KENTWELL LN
LINCOLN NE
68516-6774
US

IV. Provider business mailing address

7223 KENTWELL LN
LINCOLN NE
68516-6774
US

V. Phone/Fax

Practice location:
  • Phone: 402-499-6772
  • Fax:
Mailing address:
  • Phone: 402-499-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number1194
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: