Provider Demographics
NPI:1740028562
Name:KOTTLER, MORGEN-NICOLLE
Entity type:Individual
Prefix:
First Name:MORGEN-NICOLLE
Middle Name:
Last Name:KOTTLER
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 1:226 N MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-5351
Mailing Address - Country:US
Mailing Address - Phone:609-507-5899
Mailing Address - Fax:
Practice Address - Street 1:226 N MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-5351
Practice Address - Country:US
Practice Address - Phone:609-507-5899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20057000163WA0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)