Healthcare Provider Details

I. General information

NPI: 1568533677
Provider Name (Legal Business Name): NANCY NELLE COTTEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1487 N HIGH ST
HILLSBORO OH
45133-8496
US

IV. Provider business mailing address

PO BOX 637735
CINCINNATI OH
45263-7735
US

V. Phone/Fax

Practice location:
  • Phone: 937-840-9150
  • Fax: 937-840-0777
Mailing address:
  • Phone: 937-393-6101
  • Fax: 937-393-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11288
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-010808
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: