Basic Information
| Provider Information | |||||||||
| NPI: | 1568533677 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COTTEN | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | NELLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 637735 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452637735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373936101 | ||||||||
| FaxNumber: | 9373936278 | ||||||||
| Practice Location | |||||||||
| Address1: | 1487 N HIGH ST | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451338496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9378409150 | ||||||||
| FaxNumber: | 9378400777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2006 | ||||||||
| LastUpdateDate: | 01/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 11288 | MT | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 34-010808 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0081916 | 05 | OH | MEDICAID |