MEDICARE: MRS. JULIE ANNE KIRT 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	171M00000X	Case Manager/Care Coordinator	KY-A0580	KY

General Provider Information

NPI Number	:	1831227131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE ANNE KIRT COTA

Provider Business Mailing Address
First Line	:	4724 OAK POINTE DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-6438
Country	:	US
Telephone Number	:	502-339-9948
Fax Number	:	502-426-5442

Provider Business Practice Location Address
First Line	:	4724 OAK POINTE DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-6438
Country	:	US
Telephone Number	:	502-339-9948
Fax Number	:	502-426-5442

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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