Provider Demographics
NPI:1467771311
Name:COTE, JEANIE LYNN (MD)
Entity Type:Individual
Prefix:
First Name:JEANIE
Middle Name:LYNN
Last Name:COTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N SHIAWASSEE ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1601
Mailing Address - Country:US
Mailing Address - Phone:989-723-1390
Mailing Address - Fax:989-725-1415
Practice Address - Street 1:819 N SHIAWASSEE ST STE 110
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1601
Practice Address - Country:US
Practice Address - Phone:989-723-1390
Practice Address - Fax:989-725-1415
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010961302084N0400X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1467771311Medicaid