MEDICARE: JERROD COTTEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		NC

General Provider Information

NPI Number	:	1285506725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERROD COTTEN

Provider Business Mailing Address
First Line	:	PO BOX 217009
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28221-0009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7260 HIGHLAND CREEK PKWY
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0805
Country	:	US
Telephone Number	:	919-802-4460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ JERROD COTTEN ” Practice Location

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