Provider Demographics
NPI:1235829888
Name:COTTRELL, ALICIA SIMONE (CD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:SIMONE
Last Name:COTTRELL
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 WESTPORT WOODS LN UNIT 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-2742
Mailing Address - Country:US
Mailing Address - Phone:502-536-2255
Mailing Address - Fax:
Practice Address - Street 1:4501 WESTPORT WOODS LN UNIT 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-2742
Practice Address - Country:US
Practice Address - Phone:502-536-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula