Healthcare Provider Details

I. General information

NPI: 1285556514
Provider Name (Legal Business Name): CHERYL ANN KOTKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N MAIN ST STE 300
AKRON OH
44308-1971
US

IV. Provider business mailing address

47 N MAIN ST STE 300
AKRON OH
44308-1971
US

V. Phone/Fax

Practice location:
  • Phone: 234-271-7610
  • Fax:
Mailing address:
  • Phone: 234-271-7610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN318604
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: