Individual
MRS. KRISTINE COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 E FILLMORE ST, PHOENIX, AZ 85008-6159
(602) 683-2400
Mailing address
2929 E FILLMORE STREET, PHOENIX, AZ 85008
(602) 683-2400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP027730
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86000485
—
AZ
Enumeration date
10/28/2009
Last updated
10/28/2009
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