| Doctor Name: | KEVIN COTTLE |
| NPI Number: | 1245440478 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 3289814405 |
| Business Practice Address: | 3556 W 9800 S Suite 101 South Jordan, UT - 840953211 |
| Business Phone Number: | 8015679780 |
| Business Fax Number: | 8015679826 |
| Mailing Address: | 3556 W 9800 S, Suite 101 SOUTH JORDAN |
| State: | UT |
| Postal Code: | 840953211 |
| Phone Number: | 8013529500 |
| Fax Number: | 8013529502 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3289814405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |