Provider Demographics
NPI:1225118334
Name:COTTER, MARY PAT (NP)
Entity Type:Individual
Prefix:
First Name:MARY PAT
Middle Name:
Last Name:COTTER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:14036 SHADY POINTE CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VIRGINIA EMERGENCY ASSOCIATES INC
Practice Address - Street 2:5801 BREMO ROAD
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-287-7066
Practice Address - Fax:804-673-9531
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2019-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024134188207P00000X
VA0024164188363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0024164188OtherVIRGINIA STATE LICENSE