Provider Demographics
NPI:1306446646
Name:COTTRELL, CATHY SUE
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SUE
Last Name:COTTRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:INDORE
Mailing Address - State:WV
Mailing Address - Zip Code:25111-8047
Mailing Address - Country:US
Mailing Address - Phone:304-587-4236
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-1303
Practice Address - Country:US
Practice Address - Phone:304-765-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker