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NPI Code Detail

MEDICARE: MS. JENNIFER LYNN ANDERSON COTA

MEDICARE:  MS. JENNIFER LYNN ANDERSON  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
1314000000XSkilled Nursing Facility207966TX

General Provider Information

NPI Number : 1649478975
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER LYNN ANDERSON COTA
Provider Business Mailing Address
First Line : 6023 77TH ST
Second Line :
City : LUBBOCK
State : TX
Zip : 79424-1732
Country : US
Telephone Number : 405-819-8909
Fax Number :
Provider Business Practice Location Address
First Line : 1751 N 15TH ST
Second Line :
City : ABILENE
State : TX
Zip : 79603-4430
Country : US
Telephone Number : 325-673-8892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2007
Last Update Date : 07/09/2007

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