Provider Demographics
NPI:1558092254
Name:MOTZKUS, MAHALEY RACHEL (CRNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:MAHALEY
Middle Name:RACHEL
Last Name:MOTZKUS
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 AL HIGHWAY 157 STE B
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0672
Mailing Address - Country:US
Mailing Address - Phone:256-775-2722
Mailing Address - Fax:256-775-2648
Practice Address - Street 1:1965 AL HIGHWAY 157 STE B
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0672
Practice Address - Country:US
Practice Address - Phone:256-775-2722
Practice Address - Fax:256-775-2648
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-158185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily