Healthcare Provider Details
I. General information
NPI: 1376254284
Provider Name (Legal Business Name): JENNA LYNN STROMER COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/12/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7818 BIG SKY DR
MADISON WI
53719
US
IV. Provider business mailing address
W2765 BROOKHAVEN DR
APPLETON WI
54915
US
V. Phone/Fax
- Phone: 608-709-7070
- Fax:
- Phone: 920-639-2414
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224Z00000X |
| Taxonomy | Occupational Therapy Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: