Provider Demographics
NPI:1871281030
Name:COTTRELL, MINDY SUE
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:SUE
Last Name:COTTRELL
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 1:1020 E BOWMAN ST
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-3120
Mailing Address - Country:US
Mailing Address - Phone:330-601-7208
Mailing Address - Fax:
Practice Address - Street 1:1251 NELSON AVE
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1425
Practice Address - Country:US
Practice Address - Phone:330-601-7208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide