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Individual

JENNIFER COTHRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1587 NW WASHINGTON BLVD, GRANTS PASS, OR 97526-1085
(541) 476-7000
Mailing address
1701 NE 7TH ST, GRANTS PASS, OR 97526-1319

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
28188603A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201394830
IN
01
P01723962
RR MEDICARE
IN
Enumeration date
05/06/2016
Last updated
11/26/2024
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