Basic Information
Provider Information
NPI: 1275959678
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COTTEN
FirstName: ANDREW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2341 MCCALLIE AVE
Address2: SUITE 402
City: CHATTANOOGA
State: TN
PostalCode: 374043239
CountryCode: US
TelephoneNumber: 4236482720
FaxNumber: 4236246355
Practice Location
Address1: 110 29TH AVE N STE 202
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372031448
CountryCode: US
TelephoneNumber: 6153274304
FaxNumber: 6153277940
Other Information
ProviderEnumerationDate: 03/10/2014
LastUpdateDate: 11/26/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN0000171827TNN Nursing Service ProvidersRegistered Nurse 
367500000XAPN19114TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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