Healthcare Provider Details

I. General information

NPI: 1568421634
Provider Name (Legal Business Name): RASHEDA A COTTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 N 55TH ST
MILWAUKEE WI
53216-2810
US

IV. Provider business mailing address

3520 N 55TH ST
MILWAUKEE WI
53216-2810
US

V. Phone/Fax

Practice location:
  • Phone: 414-499-6589
  • Fax: 414-449-9658
Mailing address:
  • Phone: 414-499-6589
  • Fax: 414-449-9658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12217-33
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0143622-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: