Individual
JEAN COTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
118 SHORE DR, MUKWONAGO, WI 53149-1315
(262) 363-4429
(262) 363-0558
Mailing address
118 SHORE DR, MUKWONAGO, WI 53149-1315
(262) 363-4429
(262) 363-0558
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
75622-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35045100
—
WI
Enumeration date
11/05/2007
Last updated
11/05/2007
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