Individual
ALLISON KOTTACKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1022 E MAIN ST, BENTON HARBOR, MI 49022-3036
(269) 926-0015
(269) 281-4475
Mailing address
1022 E MAIN ST, BENTON HARBOR, MI 49022-3036
(269) 926-0015
(269) 281-4475
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209011039
IL
Other
Enumeration date
04/22/2014
Last updated
05/31/2022
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