Provider Demographics
NPI:1710646302
Name:COTTER, ESTELLA IRENE (RN, CHT)
Entity Type:Individual
Prefix:MRS
First Name:ESTELLA
Middle Name:IRENE
Last Name:COTTER
Suffix:
Gender:F
Credentials:RN, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2293 KEENEY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6089
Mailing Address - Country:US
Mailing Address - Phone:907-888-6585
Mailing Address - Fax:
Practice Address - Street 1:15333 N PIMA RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2783
Practice Address - Country:US
Practice Address - Phone:480-422-5068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ265129163W00000X, 163WC1500X, 163WL0100X, 163WN1003X, 163WP0808X
AKNURR32833163WC1500X, 163WL0100X, 163WM0102X, 163WN1003X, 163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health