Provider Demographics
NPI:1760115737
Name:COTTINGHAM, RASHIDA
Entity Type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:COTTINGHAM
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 1:1664 TERRY DALE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-8934
Mailing Address - Country:US
Mailing Address - Phone:262-957-4162
Mailing Address - Fax:
Practice Address - Street 1:1664 TERRY DALE DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-8934
Practice Address - Country:US
Practice Address - Phone:262-957-4162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0018878374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide