Provider Demographics
NPI:1942337563
Name:KOTHMANN, CECELIA A (FNP)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:A
Last Name:KOTHMANN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 10TH ST
Mailing Address - Street 2:SUITE 101, PMB 118
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-1867
Mailing Address - Country:US
Mailing Address - Phone:830-996-3701
Mailing Address - Fax:830-996-3749
Practice Address - Street 1:601 PERSON STREET
Practice Address - Street 2:
Practice Address - City:STOCKDALE
Practice Address - State:TX
Practice Address - Zip Code:78160-9998
Practice Address - Country:US
Practice Address - Phone:830-996-3701
Practice Address - Fax:830-996-3749
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238956363LA2200X
TXAP111061363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health