Provider Demographics
NPI:1407725294
Name:COTTEN-BEAL, MINNIE
Entity type:Individual
Prefix:
First Name:MINNIE
Middle Name:
Last Name:COTTEN-BEAL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-1959
Mailing Address - Country:US
Mailing Address - Phone:262-484-8336
Mailing Address - Fax:
Practice Address - Street 1:3919 31ST AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-1959
Practice Address - Country:US
Practice Address - Phone:262-484-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company