MEDICARE: MRS. SHERELL LANETTE COTTON-HILL RN

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	163W00000X	Registered Nurse	359297	OH

General Provider Information

NPI Number	:	1588972335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERELL LANETTE COTTON-HILL RN

Provider Business Mailing Address
First Line	:	5216 PARKLINE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-5217
Country	:	US
Telephone Number	:	614-772-3098
Fax Number	:

Provider Business Practice Location Address
First Line	:	5216 PARKLINE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-5217
Country	:	US
Telephone Number	:	614-772-3098
Fax Number	:

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

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	09/15/2010

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