Provider Demographics
NPI:1518647734
Name:COTTRELL, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
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 1:673 CORTE MADERA AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-2974
Mailing Address - Country:US
Mailing Address - Phone:702-596-5136
Mailing Address - Fax:702-357-8317
Practice Address - Street 1:673 CORTE MADERA AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-2974
Practice Address - Country:US
Practice Address - Phone:702-596-5136
Practice Address - Fax:702-357-8317
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant