1467585182 NPI number — MISS SABRINA RENEE COTTON

Table of content: MISS SABRINA RENEE COTTON (NPI 1467585182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467585182 NPI number — MISS SABRINA RENEE COTTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COTTON
Provider First Name:
SABRINA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467585182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4015 LAKESIDE DR APT 503
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71302-3171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-561-7265
Provider Business Mailing Address Fax Number:
318-484-6228

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2129 RAINBOW DR
Provider Second Line Business Practice Location Address:
242 W SHAMROCK STREET
Provider Business Practice Location Address City Name:
PINEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71360-6449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-484-6469
Provider Business Practice Location Address Fax Number:
318-484-6228
Provider Enumeration Date:
03/13/2007

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: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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