Provider Demographics
NPI:1043031586
Name:COTTRILL, RACHEL DOVE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DOVE
Last Name:COTTRILL
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 1:555 Q ROAD
Mailing Address - Street 2:
Mailing Address - City:AURTHURDALE
Mailing Address - State:WV
Mailing Address - Zip Code:26520
Mailing Address - Country:US
Mailing Address - Phone:304-400-3895
Mailing Address - Fax:
Practice Address - Street 1:555 Q ROAD
Practice Address - Street 2:
Practice Address - City:AURTHURDALE
Practice Address - State:WV
Practice Address - Zip Code:26520
Practice Address - Country:US
Practice Address - Phone:304-400-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant