=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316814965
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | INNA FELDMAN COTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2025
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4700 LAS VEGAS BLVD NORTH NELLIS AFB BLDG 1300
-----------------------------------------------------
City | APO
-----------------------------------------------------
State | AA
-----------------------------------------------------
Zip | 89191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-653-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 218 ABBEY HILL ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89012-5034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-653-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 224Z00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapy Assistant
-----------------------------------------------------
License Number | OTA-2407
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------