Provider Demographics
NPI:1962974550
Name:DR. MANDY COTTEN FNP-C, P.A.
Entity type:Organization
Organization Name:DR. MANDY COTTEN FNP-C, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:COTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:817-467-7474
Mailing Address - Street 1:4224 PARK SPRINGS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4729
Mailing Address - Country:US
Mailing Address - Phone:817-467-7474
Mailing Address - Fax:817-468-8643
Practice Address - Street 1:4224 PARK SPRINGS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4729
Practice Address - Country:US
Practice Address - Phone:817-467-7474
Practice Address - Fax:817-468-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty