Provider Demographics
NPI:1437436342
Name:COTTER, KAITLIN ELIZABETH
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:ELIZABETH
Last Name:COTTER
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 1:17 TROUT BROOK RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4125
Mailing Address - Country:US
Mailing Address - Phone:978-985-8633
Mailing Address - Fax:
Practice Address - Street 1:203 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3377
Practice Address - Country:US
Practice Address - Phone:603-870-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-05
Last Update Date:2011-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist