Provider Demographics
NPI:1427843549
Name:KOTLYN, ROSALYN (RN)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:KOTLYN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 HONEYGOLD LN
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-3630
Mailing Address - Country:US
Mailing Address - Phone:440-570-7266
Mailing Address - Fax:
Practice Address - Street 1:1414 HONEYGOLD LN
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-3630
Practice Address - Country:US
Practice Address - Phone:440-570-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.270403163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health