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MRS. CRYSTAL KERSEY COTRELL PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1205849973

Individual Registrant:
MRS. CRYSTAL KERSEY COTRELL PA-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
58 BIG A RD  TOCCOA, GA 30577 US
Tel: 706-282-4200  Fax: 706-886-8045

Contact information for business:
58 BIG A RD  TOCCOA, GA 30577-6017 US
Tel: 706-282-4200  Fax: 706-886-8045

Registration Information:
NPI: 1205849973
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
GA004427

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
620119937CGA05




HEALTH CARE JOBS GA - Page 1



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