Healthcare Provider Details

I. General information

NPI: 1457509994
Provider Name (Legal Business Name): MRS. CHRISTEAN COTTINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BRECKSVILLE RD
BRECKSVILLE OH
44141-3204
US

IV. Provider business mailing address

20640 SELFRIDGE PKWY
HIGHLAND HILLS OH
44122-7042
US

V. Phone/Fax

Practice location:
  • Phone: 440-526-3030
  • Fax: 440-740-2397
Mailing address:
  • Phone: 216-561-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN128167
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: