Individual
MARIA KOTTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FPMHNP-BC
Contact information
Practice address
3222 EDEN TRL, BRIGHTON, MI 48114
(810) 623-1226
Mailing address
3222 EDEN TRL, BRIGHTON, MI 48114-9185
(810) 623-1226
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704164862
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704164862
NONE
MI
Enumeration date
09/10/2013
Last updated
09/10/2013
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