MEDICARE: SHELLY PETERSON COTA

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	224Z00000X	Occupational Therapy Assistant	5194-27	WI

General Provider Information

NPI Number	:	1346600889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY PETERSON COTA

Provider Business Mailing Address
First Line	:	326 S PRAIRIE ST
Second Line	:
City	:	PRAIRIE DU CHIEN
State	:	WI
Zip	:	53821-1723
Country	:	US
Telephone Number	:	608-433-8493
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 S PRAIRIE ST
Second Line	:
City	:	PRAIRIE DU CHIEN
State	:	WI
Zip	:	53821-1723
Country	:	US
Telephone Number	:	608-433-8493
Fax Number	:

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

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	05/28/2019

Similar Medicare Providers

1063368603 — ABBEY DEDDO
Practice Location Address:

200 N DIVISION ST
DU QUOIN, IL
62832-1723

Practice Phone: 618-542-5954
Practice Fax: 618-542-8592

1487656765 — PRAIRIE NURSING FACILITY LLC
Practice Location Address:

700 S. FREMONT STREET
PRAIRIE DU CHIEN, WI
53821

Practice Phone: 608-326-8471
Practice Fax: 608-326-3205

1295739035 — RALPH E TAUKE MD
Practice Location Address:

610 E TAYLOR ST
PRAIRIE DU CHIEN, WI
53821-2109

Practice Phone: 608-326-6466
Practice Fax:

1750385621 — MARILU BINTZ MD
Practice Location Address:

610 E TAYLOR ST
PRAIRIE DU CHIEN, WI
53821-2109

Practice Phone: 608-326-6466
Practice Fax:

1003810821 — WALTER R BOISVERT MD
Practice Location Address:

610 E TAYLOR ST
PRAIRIE DU CHIEN, WI
53821-2109

Practice Phone: 608-326-6466
Practice Fax:

1881698306 — ROCHELLE L NEISIUS APNP
Practice Location Address:

610 E TAYLOR ST
PRAIRIE DU CHIEN, WI
53821-2109

Practice Phone: 608-326-6466
Practice Fax:

Directions to “ SHELLY PETERSON COTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.