1679242879 NPI number — MRS. WHITNEY BRIANNE COTTEN LPN

Table of content: MRS. WHITNEY BRIANNE COTTEN LPN (NPI 1679242879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679242879 NPI number — MRS. WHITNEY BRIANNE COTTEN LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COTTEN
Provider First Name:
WHITNEY
Provider Middle Name:
BRIANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NEVELS
Provider Other First Name:
WHITNEY
Provider Other Middle Name:
BRIANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679242879
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7686 VINCENT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENHAM SPRINGS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70726-5655
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-665-8198
Provider Business Mailing Address Fax Number:
225-665-9713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7686 VINCENT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENHAM SPRINGS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70726-5655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-665-8198
Provider Business Practice Location Address Fax Number:
225-665-9713
Provider Enumeration Date:
09/10/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  280011 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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