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General NPI Number Information
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NPI Number | 1396443578
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Entity Type | Individual
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Provider Name | BAILEY NICOLE JENKINS COTA
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Gender | Female
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 2480 US 41 N
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City | HENDERSON
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State | KY
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Zip | 42420-2300
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Country | US
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Telephone | 270-823-3875
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Fax | 270-212-0271
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Provider Business Mailing Address
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Address Line | 5442 STATE ROUTE 1299
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City | ROBARDS
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State | KY
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Zip | 42452-9579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 283350
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License Number State | KY
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