Provider Demographics
NPI:1700366838
Name:COTNER, MELISSA MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:COTNER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 N MERIDIAN RD # 8085
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-4805
Mailing Address - Country:US
Mailing Address - Phone:406-890-8824
Mailing Address - Fax:
Practice Address - Street 1:350 HERITAGE WAY STE 1100
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3160
Practice Address - Country:US
Practice Address - Phone:406-752-8900
Practice Address - Fax:406-752-8909
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-131886363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care