Healthcare Provider Details

I. General information

NPI: 1922918762
Provider Name (Legal Business Name): NADINE L COTTERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BEAR DR
GREENVILLE SC
29605-4458
US

IV. Provider business mailing address

122 CREEK SHOALS DR
SIMPSONVILLE SC
29681-6580
US

V. Phone/Fax

Practice location:
  • Phone: 864-844-9432
  • Fax:
Mailing address:
  • Phone: 864-844-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number32633
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: