MEDICARE: NICOLE MES COTTER M.D.

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	207RR0500X	Rheumatology Physician	MD201595	LA
2	207RR0500X	Rheumatology Physician	DR.0064147	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5H929C980	OTHER		MEDICARE PTAN

General Provider Information

NPI Number	:	1831390962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MES COTTER M.D.

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:	970-624-4128
Fax Number	:	970-490-4340

Provider Business Practice Location Address
First Line	:	940 CENTRAL PARK DR STE 190
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-8853
Country	:	US
Telephone Number	:	970-875-2619
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	09/23/2020

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Directions to “ NICOLE MES COTTER M.D.” Practice Location

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