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NPI Code Detail

MEDICARE: KELLI M NEAL COTA

MEDICARE: KELLI M NEAL 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
1224Z00000XOccupational Therapy Assistant1209027WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780889600
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI M NEAL COTA
Provider Business Mailing Address
First Line : 3401 MAPLE GROVE DR
Second Line :
City : MADISON
State : WI
Zip : 53719-5013
Country : US
Telephone Number : 608-845-1000
Fax Number : 608-845-1001
Provider Business Practice Location Address
First Line : 3401 MAPLE GROVE DR
Second Line : ST MARYS CARE CENTER
City : MADISON
State : WI
Zip : 53719-5013
Country : US
Telephone Number : 608-845-1000
Fax Number : 608-845-1001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2007
Last Update Date : 05/13/2008

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Directions to “ KELLI M NEAL COTA” Practice Location

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