Healthcare Provider Details

I. General information

NPI: 1720652274
Provider Name (Legal Business Name): NIKKI COTTEN WESTBROOK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 RIVER CROSSING DR STE 206
FORT MILL SC
29715-7900
US

IV. Provider business mailing address

PO BOX 3051
ROCK HILL SC
29732-5051
US

V. Phone/Fax

Practice location:
  • Phone: 803-784-8731
  • Fax: 803-987-8288
Mailing address:
  • Phone: 803-784-8731
  • Fax: 803-987-8288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD86031
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: